Tuberculosis is a serious threat to the population of India which the Government and the Revised National TB Control Programme are targeting to abolish by 2025
India is a signatory to ‘the End TB Strategy’ adopted by the World Health Organisation at the World Health Assembly in 2014 that calls for a 90 per cent reduction in deaths resultant of Tuberculosis (TB) disease and an 80 per cent reduction in incidence rates by 2030.
The commitment of the Government of India was solemnly affirmed by the Finance Minister in his Budget Speech to end TB in India by 2025.
However, it must be acknowledged that the task is gigantic as India has the highest TB burden. 27 per cent of the global TB patients are in India, though the Indian population constitutes 18 per cent of the global population.
Such a huge challenge, despite demonstrated political commitment, can be met with the active cooperation of all stakeholders.
I am glad that our Members of Parliament, the supreme policy makers, came together and formed India TB Caucus in March, 2017 with a view to work collectively and individually to root out this epidemic lock, stock and barrel.
In order to attain this Sustainable Development Goal (SDGs) and to ‘end TB’, the Government of India, through the Revised National Tuberculosis Control Programme (RNTCP) has forged newer strategies and tools to combat, control and eradicate TB from our midst.
India has made perceptible progress in TB control, yet, we continue to have the largest TB burden globally. Every year around 2.8 million or 28 lakh people develop TB in India and an estimated 480,000 people die of TB. Nearly one life is lost every minute to TB. 40 per cent of the adult population in India is already infected with latent TB who have 10 per cent lifetime risk of developing it.
The incidence of latent disease will have to be addressed squarely, otherwise the results will be much more frightening. To me, it often seems that despite the progress made, we continue to be far behind in the control of the TB epidemic. Therefore, it calls for far greater mobilisation of finances and health professionals and policymakers to put an end to this menace as early as we can and in any case by 2025 as resolved by the country.
The RNTCP, an ambitious plan with multi-pronged strategy drawn by the Government in concert with the stakeholders, stipulates mandatory notification of all cases of Tuberculosis, use of state-of-the-art technology for diagnosis and conclusive failsafe treatment.
The Pharmacovigilance Program of India of the Government aims to systematically identify, detect and manage adverse effect of drugs. We have also developed and put in place a case-based web notification system, where the private sector, doctors and the labs can notify the cases of TB.
let me spell out the objectives of our TB control programme, which are as follows —
(a) To reduce the incidence and mortality due to TB
(b) To prevent drug resistance and effectively manage drug-resistance TB cases
(c) To improve outcomes among human immunodeficiency virus (HIV)-infected TB patients; and
(d) To involve private sector on a scale commensurate with their dominant presence in healthcare services in India.
I have some satisfaction that through effective policies and sustained programme interventions, we have been able to bring down drastically the TB related deaths to four per cent from 29 per cent earlier. Our determined efforts are to make India TB free.
The Government is committed to engage continuously with the private sector to further increase access to patients for a public health impact. Our public-private interference agency schemes in Mumbai and Patna have shown encouraging results and we hope that many more such experiments will be undertaken nationwide soon.
We recognise that the private sector and the community holds a factual predominance of healthcare service delivery in India and TB is no exception. Engaging the private sector effectively is the single most important intervention required for India to achieve the overall goal of universal access to quality TB care. Our goal continues to be to achieve the vision of universal access to quality diagnosis and treatment of TB for all.
We also need participation from other health and development programs such as HIV, Diabetes, nutrition, and urban planning. It needs a multi-sectoral but synergetic approach spreading across Ministries and Governments, both Union and States.
Urban slums, mines, stone crushing sites, bidi and glass industry workers, unorganised sector labourer, prisons, asylums, orphanages, destitutes, and similarly situated hapless people — all need to be addressed and taken within the fold of programmatic interventions to achieve the goal of ‘end TB’.
Unless we receive this support, its unlikely we will be able to address these challenges in a comprehensive manner to score victory over the disease that is recurrent and affects our vast population across the country.
In our sustained endeavours to overcome the challenges, we need to devise innovative strategies and take new initiatives to ensure that we meet our goal and make India fully TB-free.
For this, we need support from the policy-makers, public representatives, civil society, patients, private sector representatives and the media.
I again wish to reiterate the solemn resolve of the Government of India to accelerate the TB diagnostic and treatment programme and to make it accessible, affordable and effective.
The honourable Prime Minister Narendra Modi has directed that we prepone and achieve the SDG target of 2030 by 2025.
We are determined to achieve the target by 2025. Our focus is on reducing out-of-pocket expenditure for TB patients by taking care of the cost of diagnostics, treatment and travel. The RNTCP also provides for nutrition to the TB patients and plans to compensate for wage loss of the patients.
We have instituted an electronic payment system to ensure direct cash transfer to the beneficiary patients by plugging every possible leakage.
I congratulate all those who are working in tandem with the Government to achieve the the goal of a TB free India. The Government of India is absolutely determined and resolute to meet every single challenge and hurdle. let’s all lend our unwavering support and unflinching commitment to safeguard the right to life of every Indian. let’s work together for making a swachh Bharat, swasth Bharat and a TB-mukt Bharat.
(The writer is a Union Minister. This is an edited speech delivered by him recently at the Centre-State Summit on TB)