Context:

World Health Organization (WHO) has released the 2019 edition of the Global Tuberculosis (TB) Report.

Global Tuberculosis (TB) Report:

• The report provides a comprehensive and up-to-date assessment of the TB epidemic and progress in the response at global, regional and country levels for India.
• It also features data on disease trends and the response to the epidemic in 202 countries and territories.
• This includes trends in TB incidence and mortality, data on case detection and treatment results for TB, multidrug-resistant TB (MDR-TB), TB/HIV, TB prevention, universal health coverage as well as financing

Details:

• The tuberculosis incidence rate in India has decreased by almost 50,000 patients over the past one year, according to the Report.
• The treatment success rate has increased to 81% for new and relapse cases (drug-sensitive) in 2017, which was 69% in 2016.
• In India, of the estimated 2.69 million TB cases emerging in 2018, 2.15 million were reported to the Government of India — leaving a gap of 5,40,000 patients who are going unreported.
• The India TB-Report 2019 notes that India is closest ever to covering all TB cases through the online notification system (NIKSHAY).

Conclusion:

According to experts, TB remains the top infectious killer in the world claiming over 4,000 lives a day. This report presents progress towards targets set at the first-ever United Nations General Assembly high-level meeting on TB in 2018, that brought together heads of state, as well as the targets of the WHO End TB Strategy and Sustainable Development Goals.

What is Tuberculosis (TB)?

• The Mycobacterium tuberculosis bacterium causes TB.
• It is spread through the air when a person with TB (whose lungs are affected) coughs, sneezes, spits, laughs or talks.
• Since antibiotics began to be used to fight TB, some strains have become resistant to drugs.
• Multidrug-resistant TB (MDR-TB) arises when an antibiotic fails to kill all of the bacteria that it targets, with the surviving bacteria developing resistance to that antibiotic and often others at the same time.

What are the key challenges being faced by the government in its quest to restrict the spread of TB?

• There is no initial categorization of patients. The Category of TB that a patient is suffering from is not checked in the beginning and the first-line treatment is given which is useless for MDR cases thereby worsening the situation.
• TB treatment should be on a daily basis however alternate day treatment leaves the programme ineffective.
• There is poor monitoring of the fact whether the patient is regularly taking the doses or not. This is often wrongly reported.
• Actual number of cases reported in the National Register for TB is far less than the number of patients actually affected and hence the disease, being contagious, keeps on spreading.
• Demand and supply gap of the drugs is quite wide. Specific drugs are rather expensive, especially for the rural masses. There is lack of research and research-related funding towards patient-specific drugs.

• The TB Programme continues to face the challenge of under-reporting of cases from the private sector, which caters to a majority of cases.
• There is a poor sense of awareness and responsibility on the patient’s part to complete the TB course.

Nikshay:

• A web-based application called ‘Nikshay’ was launched in 2012 to help providers notify cases to the authorities.
• Doctors need to download the app. The data of the patients entered in the app will be linked to a server in CTD. This will help avoid its duplication.
• Apart from web-based technology, SMS services have been used effectively for communication with patients and monitoring the programme on a day-to-day basis.
• It has been developed by National Informatics Centre (NIC).