Article

Introduction

Caused by the bacterium Mycobacterium Tuberculosis, Tuberculosis (TB) is a disease that has plagued the world since ancient times. The bacteria majorly target the lungs but can also affect other organs such as the kidney, brain and spine. TB is a communicable disease that may spread through the air. The disease is partially curable by vaccination; however, in case of severe infection or comorbidity, it may become fatal.

Tuberculosis: A Global crisis

As per the World Health Organisation’s (WHO’s) data, the South-East Asian region constituted 43% of new cases of TB, followed by the African region and Western Pacific region with 25% and 18% of cases respectively in 2020. TB is the 13th leading cause of death globally. It is second only to COVID-19 as the leading cause of death because of infection. In the year 2020 alone, 1.5 million people died due to TB infection. The rate of infection is falling but at a slow pace. The rate of reduction in incidents between 2015-2019 was 9% (142 to 130 per 1,00,000). The rate of deaths due to TB is also on a slow path to decline. The reduction in the death rate between 2015 and 2019 was ~14%, against the target of 30%.

Tuberculosis in India

The mention of symptoms of TB can be found in ancient texts of Vedas and Ayurvedic Samhitas. To treat and isolate the patients of TB, an open-air sanatorium was established in the year 1906 at Tiluania, near Ajmer, Rajasthan. Shortly after two years, another center was opened in Almora, Uttarakhand. Ever since then, there have been various endeavours and initiatives to curtail and eradicate the disease.

To eradicate the epidemic, the Government of India launched the National TB Programme (NTP) in 1961. To further streamline these efforts, a Revised National TB Control Programme (RNTCP) was launched in 1997 with the help of WHO and the Swedish International Development Agency. It was based on ‘Directly Observed Treatment - Short-course (DOTS)’, an internationally acclaimed strategy that could control TB. RNTCP included different kinds of funding ideas, streamlined drug supply mechanisms, better supervision, precise monitoring, and a technical support system powered by a country-wide group of consultants. RNTCP was launched as a national program in a systematically phased manner. The services were majorly launched from district to district which also led to the formation of a ‘District TB Control Society’. Such efforts by the Government of India have helped in improving the country-wide TB situation.

If we look over the facts of the last decade, RNTCP efforts by the Government have reached more than 1.1 billion people since its launch. India has also met the WHO guidelines as far as case detection and the success of treatment are concerned. Efforts under the RNTCP campaign have achieved success despite the wrath caused by the COVID-19 pandemic.

During RNTCP’s second phase between 2006-2011, the set targets of global case detection related to TB were achieved. But despite such progress, there were numerous undiagnosed and mistreated cases in the country which were driving the TB epidemic. TB was still a leading cause of illness and death among HIV/AIDS patients. This led to the creation of the National Strategic Plan for Tuberculosis Control 2012-2017. Several interventions and initiatives were a part of this program, which were also complemented by the National Health Mission.

National Strategic Plan for Tuberculosis Elimination 2017-2025

National Strategic Plan Tuberculosis elimination was formulated in the year 2017 focusing on the strategic pillars of “Detect-Treat-Prevent-Build” (DTPB). Hon’ble Prime Minister Narendra Modi also set out the vision of ‘TB Mukt Bharat’ by the year 2025. This vision complies with the United Nations’ Sustainable Development Goals to eradicate the TB epidemic by 2030. It was formulated to guide the prevention activities of stakeholders, State Governments, international organizations, research institutions, the private sector, and many other departments.

Click here to view the ‘India TB Report 2022’ by the Ministry of Health and Family Welfare, Government of India.

About ‘World Tuberculosis Day’

Each year, the 24th of March is celebrated as ‘World Tuberculosis Day’ to raise awareness about the health, social and economic consequences of TB and to encourage people to step up in the efforts to end the global epidemic. It is led by WHO each year.

Dr. Robert Koch in 1882 discovered the bacteria that caused TB and introduced the path of TB diagnostics and disease control to the world. This year’s theme ‘Invest to End TB. Saves Lives.’ conveys the message of an urgent need to invest viable resources to improve and streamline the fight against TB and to reach the desired health goals set all major countries. Click here to know more.