Context:
India bears a disproportionately high tuberculosis (TB) burden, accounting for about 27% of global TB cases. Despite national elimination goals, recent findings highlight that rural, tribal, and migrant populations face persistent and systemic challenges in accessing timely, continuous, and quality TB care, aggravated by socio-economic inequalities and disruptions during the COVID-19 pandemic.
Key Highlights:
Socio-economic and Access Constraints
• Rural and tribal communities face limited healthcare infrastructure, long travel distances, and shortage of trained personnel.
• Migrant populations experience high mobility, informal living conditions, and lack of documentation, leading to delayed diagnosis and treatment interruptions.
Care-seeking Patterns and System Gaps
• Nearly 60% of individuals with TB symptoms initially approach private healthcare providers, increasing risks of delayed notification, inconsistent treatment, and out-of-pocket expenditure.
• Absence of a nationally coordinated post-TB care framework, despite growing evidence of long-term morbidity among TB survivors.
Post-TB Health Concerns
• Research indicates many TB survivors suffer from chronic respiratory symptoms, reduced lung function, or structural lung damage, affecting productivity and quality of life.
Targeted Interventions Suggested
• Mapping non-notified migrant settlements and outreach in educational institutions and workplaces.
• Creation of an integrated migrant health framework combining TB, HIV, non-communicable diseases (NCDs), and vector-borne disease services at common delivery points.
• Strengthening digital data systems for frontline workers and establishing an online inter-state referral and tracking platform to ensure treatment continuity.
• Implementing a robust employee welfare policy for frontline workers, including financial incentives, travel reimbursement, health insurance, and standardized salaries.
Relevant Prelims Points:
• Tuberculosis (TB): Airborne infectious disease caused by Mycobacterium tuberculosis, primarily affecting lungs but can be extrapulmonary.
• Post-TB Care: Continuum of care addressing long-term physical, psychological, and social consequences after treatment completion.
• Public-Private Partnership (PPP): Essential for early diagnosis, notification, and standardized TB treatment in India.
Relevant Mains Points:
• TB elimination is closely linked to social justice, as disease burden disproportionately affects marginalized groups.
• Fragmented healthcare delivery for migrants undermines governance efficiency and health equity.
• Long-term disability among TB survivors has economic implications, reducing workforce participation and increasing healthcare costs.
• Weak inter-state coordination reflects gaps in cooperative federalism in public health.
Way Forward:
• Develop a national post-TB care policy integrated with primary healthcare.
• Institutionalize migrant-friendly health systems with portability of health records.
• Expand PPP models with strict regulatory oversight.
• Invest in digital health infrastructure and community engagement to sustain TB elimination momentum.
UPSC Relevance:
GS 2 – Social Justice, Governance
GS 3 – Economy, Human Resource Development
Prelims – Health indicators, National Disease Control Programmes