5 November 2024 : Indian Express Editorial Analysis

 1. Checking a Contagion    

(Source: Indian Express; Section: The Editorial Page; Page: 10)

Topic: GS2 – Social Justice – Health

Context:

The WHO report highlights India’s progress in TB control but emphasizes the need for accelerated efforts and improved support systems to meet the 2025 eradication goal.

What is Tuberculosis?

• Tuberculosis is a bacterial infection caused by Mycobacterium tuberculosis. It can practically affect any organ of the body. The most common ones are the lungs, pleura (lining around the lungs), lymph nodes, intestines, spine, and brain.

Transmission:

• It is an airborne infection that spreads through close contact with the infected, especially in densely populated spaces with poor ventilation.

Symptoms:

• Common symptoms of active lung TB are cough with sputum and blood at times, chest pains, weakness, weight loss, fever and night sweats.

Infection Prevalence:

• Every year, 10 million people fall ill with TB. Despite being a preventable and curable disease, 1.5 million people die from TB each year – making it the world’s top infectious killer.
• TB is the leading cause of death of people with HIV and also a major contributor to antimicrobial resistance.
• Most of the people who fall ill with TB live in low- and middle-income countries, but TB is present all over the world. About half of all people with TB can be found in 8 countries: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines and South Africa.

WHO Report on India’s Tuberculosis (TB) Progress

• The World Health Organisation’s (WHO) latest report highlights India’s progress in combating tuberculosis (TB).
• India has made notable advancements in detecting cases, treating patients, and managing the disease.
• However, despite these achievements, challenges persist that may hinder the country’s ambitious goal of eradicating TB by 2025.
• Below is an analysis of the report’s key insights on India’s successes and ongoing obstacles in TB control.

Successes in Closing the Gap between Diagnosed and Undiagnosed Cases

• The WHO report emphasizes India’s success in significantly reducing the gap between detected and undiagnosed TB cases.
• In 2023, of the estimated 27 lakh TB cases, 25.1 lakh patients were undergoing treatment, which indicates that over 85% of suspected cases received medical attention.
• This high treatment rate is vital given TB’s virulent nature; more than half of undiagnosed cases often result in death. This progress reflects the effectiveness of India’s public health campaigns and surveillance improvements over the past eight years, which have actively brought more patients into the healthcare system.

Advances in Addressing Multi-Drug Resistant TB

• The report also acknowledges India’s achievements in addressing multi-drug-resistant TB (MDR-TB). Government-led interventions, including shorter treatment regimens, have shown promise in improving patient compliance and outcomes.
• MDR-TB poses a significant challenge worldwide due to its prolonged and complex treatment requirements, but India’s progress in managing it demonstrates the potential impact of well-designed public health policies and innovations in TB care.

Reduction in TB Incidence Rates Compared to Global Trends

• India’s TB incidence has declined by 18% in the past eight years, significantly outpacing the global average of 8% decline, as reported by WHO. This achievement underscores India’s proactive approach in combating the disease.
• Nonetheless, this pace may still be insufficient to meet the country’s ambitious target of eliminating TB by 2025. Accelerated and sustained efforts, particularly in the face of social and infrastructural challenges, are essential if India is to realize this goal within the next few years.

Challenges: Awareness, Healthcare Access, and Under-nutrition

• Despite the progress, challenges such as limited awareness, inadequate healthcare access, and undernutrition continue to impede India’s TB elimination efforts.
• The Lancet reported that poor diet contributes to 35-45% of new TB cases annually, with undernutrition being a significant mortality risk for patients. While the government offers nutritional support programs for TB patients, coverage remains limited, and the financial aid is often insufficient for economically disadvantaged groups.
• This lack of comprehensive nutritional support highlights a gap in the current TB control strategy that may contribute to higher infection and mortality rates.

Financial Constraints and Support Program Limitations

• Financial constraints have also hindered India’s TB elimination strategy. WHO data shows a decrease in funding from $432.6 million in 2019 to $302.8 million in 2023.
• This reduction impacts outreach, treatment, and patient support. A study in PLOS Global Health indicated that many families affected by TB experience catastrophic costs, with WHO estimating this figure at around 20% of affected households.
• Though the government has expressed willingness to refine its TB programs, these financial limitations underscore the need for increased funding and better support mechanisms to protect vulnerable populations from the economic impacts of TB.

Potential Solutions: Expanding Health Insurance Coverage for TB Patients

• To address these challenges, the government could consider including TB patients under its national health insurance programs, especially those with severe forms of the infection.
• Such coverage could provide critical financial assistance, particularly for economically disadvantaged patients, helping them access consistent treatment and reduce financial stress.
• Expanding insurance support could complement existing programs and drive more substantial improvements in TB treatment and outcomes.

Conclusion: Sustaining Momentum for TB Elimination

• The WHO report provides a comprehensive overview of India’s strides in tackling TB while also highlighting key areas for improvement. India has made considerable progress in diagnosing, treating, and managing TB cases, and has achieved a decline in incidence rates surpassing global averages.
• However, to meet the target of eradicating TB by 2025, India must address challenges in healthcare access, nutrition, and funding. Strengthening support programs, especially for vulnerable populations, will be essential in sustaining momentum towards eliminating this long-standing public health threat.

GLOBAL TB STATISTICS

Practice Question:  Discuss the progress made by India in tackling tuberculosis (TB) as highlighted in the latest WHO report. Analyze the challenges that remain and suggest measures to achieve the 2025 TB eradication target. (250 words/15 m)