India’s TB problem

India’s TB problem

Subject : Science and technology

Section: Health

What is Tuberculosis:

• Tuberculosis (TB) is an infectious airborne bacterial disease caused by Mycobacterium tuberculosis. .
• TB commonly affects the lungs (pulmonary TB) but can also affect other parts (extrapulmonary TB)
• Tuberculosis spreads from person to person through the air, when people who are infected with TB infection cough, sneeze or otherwise transmit respiratory fluids through the air.

What is Multidrug-Resistant TB (MDR-TB):

• In MDR-TB, the bacteria that cause TB develop resistance to antimicrobial drugs used to cure the disease.
• MDR-TB does not respond to at least isoniazid and rifampicin, the 2 most powerful anti-TB drugs.
• Treatment options for MDR-TB are limited and expensive.
• CBNAAT (Cartridges Based Nucleic Acid Amplification Test) is used for early diagnosis of MDR-TB.

What is Extensively Drug-Resistant TB (XDR-TB):

• XDR-TB is a form of multidrug-resistant TB with additional resistance to more anti-TB drugs.
• People who are resistant to isoniazid and rifampicin, plus any fluoroquinolone and at least one of three injectable second-line drugs (amikacin, kanamycin, capreomycin) are said to have XDR-TB

Status of TB :

Recent Step By WHO On TB front:

• The WHO had released a Standard on Universal Access to Rapid TB Diagnostics, recommending the use of molecular diagnostics as the initial test as these are highly accurate, detect resistance to drugs, are cost-effective, and reduce treatment-related delay.
• In December 2022, WHO recommended the use of the BPaLM/BPaL regimen for DR-TB patients, which offers a much higher success rate of 89 percent and reduces the pill burden to only three to four pills a day and shortens the treatment duration.

What are measures taken by India to eradicate TB

• The National Tuberculosis Elimination Programme(NTEP) – Aims to strategically reduce TB burden in India by It was previously known as Revised National Tuberculosis Control Programme (RNTCP).
• The National Strategic Plan for TB Elimination – It was launched to achieve the target of ending TB by 2025 in a mission mode.It is a multi-pronged approach which aims to detect all TB patients with an emphasis on reaching TB patients seeking care from private providers and undiagnosed TB in high-risk populations
• Ni-kshay Poshan Yojana(Nutritional Support to TB) –  It helps to meet the nutritional requirements of TB patients, especially the underserved
• Patient Provider Support Agencies (PPSA) – To engage the private sector, Patient Provider Support Agencies (PPSA) have been rolled out across 250 districts through the domestic setup and JEET initiative
• Universal Drug Susceptibility Testing (UDST) – To ensure every diagnosed TB patient is tested to rule out drug resistance before or at the time of treatment initiation itself.
• Pradhan Mantri TB Mukt Bharat Abhiyaan – To bring together all community stakeholders to support those on TB treatment and accelerate the country’s progress towards TB elimination.
• Ayushman Bharat – Health and Wellness Centres – To decentralize comprehensive primary healthcare including TB care services at the grassroots level.
• Bedaquiline and Delamanid -Newer drugs like Bedaquiline and Delamanid have also been made available for management of DR-TB.

What are the global measures to eradicate TB:

• The WHO (World Health Organisation) has launched a joint initiative “ Treat. All. #EndTB” with the Global Fund and Stop TB Partnership.
• End TB Strategy by World Health Organization (WHO):It serves as a blueprint for countries to reduce TB incidence by 80%, TB deaths by 90%, and to eliminate catastrophic costs for TB-affected households by 2030.
• Sustainable Development Goal 3 – To end the TB epidemic by 2030.
• Moscow Declaration, 2017 to End TB.