TB Mukt Bharat: India's tuberculosis incidence dips 16%; Telangana’s Nizamabad best performer

New Delhi: After two challenging years of the pandemic, India's tuberculosis (TB) incidence has recorded a 16 percent drop.

The number of missing TB cases in India has reduced from one million in 2015 to 0.26 million in 2023, Union Health Minister Mansukh Mandaviya said recently. The missed cases are defined as the difference between the estimated number of incident cases and those notified.

The union health minister was virtually addressing the 37th board meeting of the Stop TB Partnership, hosted by the United Nations Office for Project Services (UNOPS). It is a collective force transforming the fight against TB.

Mandaviya said TB has been a global health problem for decades. “After two challenging years dominated by disruptions caused by the COVID-19 pandemic, globally we saw a reduction in TB incidence by 8.7 percent, while in India, we were able to demonstrate a reduction of 16 percent, almost double the pace,” he said.

‘India is committed to end TB’

Referring to India’s commitment towards ending TB by 2025, the Union health minister said that under its G20 Presidency, the country advocated and addressed selected concerns of global importance. It included improving the effectiveness and reach of health services using digital solutions; strengthening cooperation to enhance pharmaceutical development and manufacturing capabilities and focusing on “One Health” and Anti-Microbial Resistance -- all of these having strong resonance with India’s and the world’s fight against TB, he said.

Focus is on prevention, public participation

“With less than two years left for India’s target of 2025, our approach going forward is focusing on prevention, while we saturate coverage of services in the detection and treatment of TB,” Mandaviya stated and highlighted that with a focused and targeted engagement with the private sector through various interventions, there has been an increase in private sector notification by more than eight times over the past nine years.

“In 2023, 0.84 million patients were notified from the private sector which contributed to 33 percent, the highest ever, of total notifications. Our approach of Jan Bhagidhari, which means people’s participation, has shown how the community can help join our fight against TB,” he added.

Government initiatives

Pradhan Mantri TB Mukt Bharat Abhiyan, the world’s largest crowd-sourcing initiative, has seen over 1,50,000 Nikshay Mitra coming forward in a “Whole of Society Approach” to adopt over one million TB patients to provide them nutritional and other support they need, the minister informed.

He also highlighted the launch of the Viksit Bharat Sankalp Yatra, an outreach activity of the government where TB was among the most important health indicators with more than 38 million individuals being screened and over one million referred for testing.

The Union health minister also mentioned the other initiatives and achievements including the launch of the ‘TB Mukt Panchayat’ initiative, the securing of over five million courses of TB preventive treatment drug 3HP, and the provision of TB services at the community level in over 1.6 lakh Ayushman Arogya Mandirs.

WHO acknowledged India’s success

In its Global TB Report 2023, the WHO stated that India has made noteworthy progress in improving case detection and reversing the impact of COVID-19 on the TB program. The treatment coverage has improved to 80% of the estimated TB cases, an increase of 19% over the previous year.

WHO acknowledges India’s success in declining TB incidence by 16% (in 2022) and TB mortality reduction by 18% since 2015. The report also notes that India’s intensified case detection strategies have resulted in the highest-ever notification of cases in 2022, during which, over 24.22 lakh TB cases were notified, surpassing the pre-COVID levels.

National award for Telangana’s Nizamabad district in TB control

After receiving a silver medal in 2022, Nizamabad district was awarded a gold medal in 2023 for its successful implementation of the TB control program by the central government.

Elaborating on the TB cases and detection, assistant professor of Nizamabad Government Medical College and Hospital Dr B Viswanath said, “In the last 3 to 4 years since Covid, the case detection rate has immensely increased. The missing cases have been reduced due to greater notification about the disease and the overall load of TB patients has also come down. The main reason for this is CBNAAT advanced diagnostic technique, which gives the result within a couple of hours and can also detect drug sensitivity that is whether it is a case of multi-drug resistance (MDR) TB, which means we can promptly apply the required treatment modality if it is MDR. Apart from improved diagnostics and treatment facilities right from the primary health center (PHC) level, follow-ups of existing patients are also being undertaken by health workers.”

Dr Viswanath assured that tuberculosis, including MDR TB is completely curable if one adheres to the treatment protocol and does not miss the drug intake. HIV patients and those taking immune-suppressant drugs are more vulnerable to developing TB. However, he said that though it may not be possible to eliminate TB from the country by 2025, the cases will decrease due to the initiatives under the National TB Elimination Programme, which has focused on the improvement of infrastructure, manpower, and diagnosis in every district and village. “Focus is given on prevention, so even if the TB germ is present in the population, efforts are being taken so that it does not develop into full-blown TB,” he said.