Nikshay Poshan Yojana (NPY) for Tuberculosis (TB)

GS Paper II Governance

The support for TB patients is raised from ₹500 to ₹1,000 under the Ni-kshay Poshan Yojana (NPY) by The Union Health Ministry

Household contacts of TB patients will receive community social support under the Pradhan Mantri TB Mukt Bharat Abhiyaan (PM TB MBA).
India aims to eliminate TB by 2025, ahead of the global target of 2030.
Energy Dense Nutrition Supplementation (EDNS) introduced for patients with BMI < 18.5.
The initiative will benefit 25 lakh TB patients and 12 lakh underweight patients, costing the government ₹1,040 crore, shared 60:40 between the Centre and States.

India’s fight Against TB

National Tuberculosis Elimination Programme (NTEP): Aims for TB elimination by 2025, ahead of the global 2030 goal.
Pradhan Mantri TB Mukt Bharat Abhiyan: Provides additional patient support and encourages community involvement.
National TB Call Centre – Ni-kshay SAMPARK: Provides tele-counseling on TB treatment.
TB Mukt Panchayat Initiative: Empowers Panchayati Raj Institutions to take actions against TB.
Tribal TB Initiative: Focuses on addressing TB in tribal communities.
Mission Indradhanush: BCG vaccine is provided under this mission.

It is a centrally sponsored scheme under the National Health Mission (NHM).
Launched by: the Ministry of Health and Family Welfare
Aim: To Support TB patients through a Direct Benefit Transfer (DBT) of ₹500 per month for nutritional needs.
- All notified TB patients are eligible for the scheme.
Ni-kshay Mitras: Volunteers such as individuals, NGOs, corporates, and political parties adopt TB patients.
- They offer support in terms of nutrition, supplements, additional investigations, and vocational support.
E-Nikshay Platform: Developed by the Central TB Division in collaboration with the National Informatics Centre (NIC) and World Health Organization.
It is a web-enabled system for TB patient management under the National Tuberculosis Elimination Programme (NTEP).
- All TB patients, public or private sector, must be registered on the platform.

Coverage Issues: Despite high numbers of notified cases, a significant proportion of beneficiaries are not receiving the financial support intended to aid their treatment.
Need for Improvement: The consistent low increase in beneficiaries suggests a need for better program awareness, accessibility, and efficiency in fund distribution.
- 2022: 2.4 million notified TB cases in India.
  - Only 1.6 million (66%) received at least one month’s payment under the Ni-kshay Poshan Yoja
- 2021: Out of 2.1 million notified TB cases.
  - Only 62.1% received at least one payment.
- 2020:62% of notified TB cases received at least one month’s payment.
Geographical Disparities: Regions with high TB burden are experiencing low beneficiary payment rates, indicating challenges in program implementation and outreach.
- Delhi:Highest TB burden: nearly 546 cases per 100,000 people.
  - Only 44% of beneficiaries received at least one payment.
- Uttar Pradesh:Case notification rate: 218 per 100,000.
  - Beneficiary payment rate: 64%.
- Madhya Pradesh: Case notification rate: 214 per 100,000.
  - Beneficiary payment rate: 82%.
- Gujarat: Case notification rate: nearly 213 per 100,000.
  - Beneficiary payment rate: 63%

It is an infectious disease caused by the Mycobacterium tuberculosis bacteria, typically affecting the lungs (pulmonary TB).
Extrapulmonary TB affects other parts of the body, e.g., Gastrointestinal TB, Skeletal TB, Liver TB.
Transmission: Through air when an infected person coughs, speaks, or sneezes.
Tests for TB: Xpert MTB, RIF Ultra, and Truenat assays.
Treatment: Common drugs include isoniazid, rifampin, and pyrazinamide.
- The BCG vaccine helps in prevention.
Drug-Resistant TB refers to TB that does not respond to standard drugs. WHO classifies drug-resistant tuberculosis (DR-TB) into five types:
- Mono-resistance: Resistance to one first-line anti-TB drug
- Poly-resistance: Resistance to more than one first-line anti-TB drug, other than both isoniazid and rifampicin
- Multidrug resistance (MDR): Resistance to at least both isoniazid and rifampicin
- Pre-extensively drug-resistant TB (pre-XDR): A type of MDR TB that is resistant to a fluoroquinolone or a second-line injectable drug
- Extensively drug-resistant TB (XDR): Resistance to any fluoroquinolone, and at least one of three second-line injectable drugs, in addition to MDR

Notified TB patients: 25.52 lakh in 2023 (up from 24.22 lakh in 2022).
Case reporting: 67% from the public sector, 33% from the private sector.
Treatment success rate for Drug-Resistant TB (DR-TB): 65%.
Incidence increase: Estimated incidence of TB in 2023 rose slightly to 27.8 lakh.
Mortality rate: Remained at 3.2 lakh.
2023 achievement: India met its target of initiating treatment in 95% of diagnosed patients.
Drug resistance testing: 58% of diagnosed patients were tested for drug resistance, up from 25% in 2015.

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