Context:
A new Lancet Commission on TB reveals concerns about the global fight against tuberculosis, as TB deaths have increased for the first time in 20 years.
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- The report highlights that the decline in TB mortality rates has slowed down, with two-thirds of TB deaths occurring in eight countries, including India (33%), Indonesia (10%), and Nigeria (8%).
- The report follows up on the 2019 Lancet Commission on tuberculosis but states that the targets set by the UN High-Level Meeting in 2018 have not been met.
Major Highlights of report:
- India reported 5.04 lakh (504,000) TB deaths in 2021, compared to 5.52 lakh (552,000) in 2010, with a peak of 4.62 lakh (462,000) deaths in 2017.
- Impact of Covid-19: TB deaths increased from 1.4 million in 2019 to 1.6 million in 2021 due to the impact of COVID-19.
- According to Dr. Soumya Swaminathan (Co-author of the Report) insufficient case finding and diagnosis are significant challenges in ending TB. (approx. one-third of people with TB were undiagnosed and untreated in 2022).
Major Recommendation Of Commission:
- The report calls for the adoption of new tools to revolutionize TB prevention, diagnosis, and treatment.
- Expanding access to molecular diagnostics and AI-assisted chest x-ray technology, as well as promoting newer, shorter 1/4/6 treatment regimens.
- These regimens offer one-month, once-weekly, and six-month treatment options for TB, including drug-resistant TB.
- Nutritional support: Research in India shows that better nutrition reduced infection rates by nearly 50% and lowered mortality by nearly 60%.
Way Forward: We need human-friendly, stigma-free, need-based psychosocial interventions along with clinical interventions as TB is not just a medical but a social disease as well.
Indian Government TB Elimination Strategy : On World TB Day 2023, Prime Minister Narendra Modi at One World TB Summit, announced initiatives to help the country meet the 2025 target.
- India aims to eliminate tuberculosis (TB) by 2025, ahead of the global target set for 2030.
- The national strategic plan for 2017-2025 sets specific targets, including reporting no more than 44 new TB cases or 65 total cases per lakh population by 2025.
- An online Ni-kshay portal tracks notified TB cases.
- Improved access to molecular diagnostic tests, like CB-NAAT and TureNat, has been facilitated, with 4,760 machines covering all districts.
- A universal drug susceptibility test determines antibiotic susceptibility for all newly diagnosed cases.
- A community engagement program involves Ni-kshay mitras adopting TB patients and providing monthly nutritional support to them.
- Newer drugs like Bedaquiline and Delamanid are provided for free to TB patients, replacing the problematic injectable kanamycin.
- Trials are underway for the vaccine candidate Immuvac, which was initially designed for leprosy prevention but may also prevent TB.
- Another candidate, VPM1002, is a modified form of the BCG vaccine with improved TB antigen expression to enhance immunity against TB.
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Source: The Indian Express
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