India’s 100-Day TB Elimination Campaign

GS II-Health

In a determined effort to eradicate tuberculosis (TB) in India, the Ministry of Health and Family Welfare is preparing to roll out a 100-day campaign aimed at TB elimination.

About the Initiative  

This campaign will be implemented across 33 States and Union Territories to strengthen TB detection, minimize diagnostic delays, and enhance treatment outcomes. India has set an ambitious target of eliminating TB by 2025, five years ahead of the global 2030 goal.

Global and National TB Scenario

• Global TB Cases: TB remains the deadliest infectious disease, surpassing COVID-19, with 8.2 million new cases recorded in 2023.
• India’s TB Burden: India leads globally in TB cases, reporting 2.8 million cases in 2023.
• Global Contribution: India accounted for 26% of the world’s TB cases and 29% of global TB-related deaths (315,000 deaths). Other high-burden countries include Indonesia (10%), China (6.8%), the Philippines (6.8%), and Pakistan (6.3%).
• Multidrug-Resistant TB: India represents 27% of the world’s multidrug-resistant TB cases, necessitating advanced treatment strategies.

Understanding Tuberculosis (TB)

TB is an airborne infectious disease caused by Mycobacterium tuberculosis, primarily affecting the lungs but also impacting other organs like the kidneys, brain, and spine.

Mode of Transmission

TB spreads through air when an infected person coughs, sneezes, or spits.

Symptoms

• Persistent cough (sometimes with blood)
• Chest pain
• Fatigue and weakness
• Weight loss
• Fever and night sweats

Prevention and Treatment

• Antibiotic Treatment: TB is both preventable and curable with a proper course of antibiotics.
• Vaccine: The Bacillus Calmette-Guérin (BCG) vaccine is currently the only available TB vaccine, offering moderate protection, particularly in young children.

Challenges in Eliminating TB in India

1. Drug-Resistant TB: The prevalence of multidrug-resistant TB (MDR-TB) makes treatment complex, requiring costlier and prolonged drug regimens.
2. Diagnosis and Case Detection: Many regions lack modern diagnostic facilities, leading to delays in accurate identification.
3. Healthcare Infrastructure: Limited healthcare facilities, particularly in rural areas, result in late detection and spread of TB.
4. Stigma and Awareness: Social stigma discourages people from seeking timely treatment, further exacerbating the disease burden.
5. Engagement with the Private Sector: A large portion of healthcare services in India are delivered by private providers, making coordination and standardization of TB treatment challenging.
6. Treatment Adherence: The long duration of TB treatment often leads to patients discontinuing medication, increasing the risk of drug resistance.
7. Vulnerable Populations: Migrant workers, slum dwellers, and those living in crowded conditions are at a higher risk of TB infection.

Government Initiatives for TB Elimination

• Revised National Tuberculosis Control Program (RNTCP): Introduced in 1997, this program has undergone multiple revisions to enhance TB control strategies.
• National Tuberculosis Elimination Program (NTEP): India has implemented the National Strategic Plan (2017-25) to achieve TB elimination by 2025.
• Pradhan Mantri TB Mukt Bharat Abhiyan (PMTBMBA): Launched in 2022 to provide TB patients with nutritional, diagnostic, and vocational support through community involvement.
• Universal Drug Susceptibility Testing (DST): Efforts have been scaled up to ensure universal access to drug resistance testing, enabling early identification and targeted treatment.
• Ni-kshay Portal: A digital platform established to track notified TB cases across the country.
• New TB Drugs: Introduction of newer drugs like Bedaquiline and Delamanid for drug-resistant TB cases, provided free of cost to patients.
• Research and Development: Studies are underway to test shorter anti-TB drug regimens to improve treatment adherence.
• Vaccine Development: Ongoing trials are assessing new vaccines like Immuvac and VPM1002 to enhance TB prevention strategies.

Recommendations for TB Control

• Establish and enforce global and national standards for TB prevention and treatment.
• Develop evidence-based policies to enhance TB care and control.
• Continuously monitor and report TB epidemic trends and funding to improve global and regional response efforts.

India’s mission to eliminate TB by 2025 requires a collaborative approach, integrating public health policies, private sector engagement, and community awareness to effectively tackle this public health challenge.