Lancet Commission flags concern over surge in tuberculosis deaths

PWOnlyIAS

September 14, 2023

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.


Source:
The Indian Express

 

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