The call for person-centred solutions in TB control in India highlights the urgent need for improved healthcare strategies.

Challenges associated with Tuberculosis

• Crisis: Tuberculosis (TB) remains a major health crisis in India and globally. 
• Issues: Elimination efforts are slow, with gaps in diagnosis, treatment, and support.
• Multifaceted Challenge: TB is not just a medical issue; it is also a social, economic, and gendered crisis.
• Lack of Holistic Approach: Historically, TB policies have been designed without fully considering the perspectives of patients.
• Impact: TB disproportionately affects marginalised groups. Children, the urban poor, prisoners, and people with HIV/AIDS.
  • It is also an economic crisis, pushing families into poverty and debt. The economic burden of TB costs India billions annually.

Solutions to Eliminate Tuberculosis

• Person Centric Approach: Current strategies must evolve to prioritize patients and communities. A person-centred approach ensures:
  • Better access to quality care.
  • More effective treatment adherence.
  • Stronger community engagement in TB control.
• Integration:  Survivors, health experts, and policymakers advocate for patient-centric TB management. Integrating lived experiences into policy can improve outcomes and accelerate TB elimination efforts.
• Reshaping Policies: TB survivor advocates have helped reshape policies to reflect real patient needs. Key improvements include:
  • Nutritional support programs (though still limited).
  • Addressing stigma and gender disparities.
  • Expanding patient support initiatives.
• Priorities for India: India’s key priorities include expanding TB testing, particularly in rural and underserved areas, ensuring access to free, high-quality TB drugs.
  • Making molecular testing widely available—currently received by less than a quarter as their first test—and addressing persistent drug and diagnostic shortages.
• Humanizing TB care: It  requires strengthening community-based models to provide comprehensive support beyond medical treatment, including mental health support and gender-responsive care. 
  • This approach addresses social, economic, and mental health needs while reducing stigma and ensuring easier access to treatment.
• Empowering Health Workers: Strengthen TB supply chains to prevent drug and diagnostic shortages. 
  • Decentralise TB services to bring care closer to patients. Empower local communities and health workers to improve outreach and patient adherence.
• Multi Sectoral Approach: Addressing socio-economic determinants of TB requires a multi-sectoral approach, including poverty alleviation programs, nutritional support to reduce incidence, and improvements in housing and air quality. 
  • Recent studies show that nutritional interventions significantly lower TB rates.
• Digital Health Solutions: AI-powered diagnostics can enhance TB detection accuracy. Digital tools for adherence tracking and surveillance can improve treatment outcomes. Remote monitoring systems can support patients in underserved areas.
• Advancements in Vaccination: Investment in better TB vaccines is crucial for long-term elimination.

Conclusion

Person-centred care must be at the core of TB policies, with a strong focus on addressing social determinants such as poverty, nutrition, and living conditions. Embracing innovation can break barriers to TB control and ensure a healthier future.

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