Analysing India's Tuberculosis Scenario: A Review of the India TB Report 2024

Understanding Tuberculosis

- Tuberculosis, caused by Mycobacterium tuberculosis, is a bacterial infection that can affect practically any organ of the body.

- Common symptoms include coughs with sputum and blood at times, chest pains, weakness, weight loss, fever and night sweats.

- It's an airborne infection that spreads through close contact with the infected.

- Despite being preventable and curable, it remains as the world's top infectious killer with 1.5 million people dying from TB each year. 

- TB is the leading cause of death among HIV patients and a major contributor to antimicrobial resistance.

- Majority of TB-infected people live in low and middle-income countries with about half the patients found in 8 countries including Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines, and South Africa.

Detailed Dive into the 2024 India TB Report

- The TB Report 2024 highlights that the TB mortality rate in India declined from 28 per lakh population in 2015 to 23 per lakh population in 2022.

- The Report states that the majority of TB cases in India are reported by the government health centres.

- It details an increase in TB notifications by the private sector with 33% of the total cases reported in 2023 coming from it.

- Despite setting ambitious goals, India faces challenges in meeting these TB elimination targets, including high prevalence of undernourishment, HIV, diabetes, alcohol use, and smoking.

Underlying Factors Affecting TB Incidence and Treatment Outcomes

- Seven out of ten TB patients were found to be undernourished which has led the government to provide monthly support to nearly one crore beneficiaries.

- People with HIV were 20 times more likely to develop TB symptoms than the normal population.

- There is a strong correlation between TB contraction and diabetes, alcohol and tobacco use, all of which weaken the immune system thus increasing vulnerability to the disease.

- To remedy this, initiatives like the Ni-kshay Mitra programme have been created to provide nutritional support.

TB Treatment and Associated Challenges

- TB is treated using a standard course of 4 antimicrobial drugs under professional supervision.

- Anti-TB medicines used over decades have led to rise of resistant strains known as Multidrug-Resistant Tuberculosis (MDR-TB) and Extensively Drug-resistant TB (XDR-TB), who do not respond to first and second-line anti-TB drugs, respectively.

- Drugs like Isoniazid and Rifampicin form the basis of TB treatment, while newer drugs like Delamanid are used in treating MDR-TB.

Global and National Initiatives to Combat TB

- The Global Plan to End TB is a blueprint that outlines priority actions and required resources to end TB, with an aim to eliminate TB by 2030.

- The WHO has teamed up with the Global Fund and Stop TB Partnership to launch the “Find. Treat. All. #EndTB” initiative.

- India's efforts towards eliminating TB include schemes like the Pradhan Mantri TB Mukt Bharat Abhiyan, National Strategic Plan for Tuberculosis Elimination, TB Harega Desh Jeetega Campaign and Nikshay Poshan Yojna.

- Further, Regional Prospective Observational Research for Tuberculosis (RePORT India) is an Indo-US initiative aiming at addressing the TB threat in India.