One World TB Summit

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    • Recently,  the Prime Minister addressed the One World TB Summit and announced initiatives for elimination of Tuberculosis by 2025 .

    About

    • One World TB Summit is organised by the Ministry of Health to take forward the Indian vision of ‘One Earth, One Health’ .
    • To achieve the goal of elimination Of TB by 2025 the PM announced TB-Mukt Panchayat, and shorter TB Preventive Treatment (TPT).
    • India also became the first country to build a functional mathematical model to estimate TB. The mathematical model was presented before the delegates from 40 countries taking part in the 36th Stop TB Partnership Board.

    TB Burden:

    • According to the WHO, A total of 1.6 million people died from TB in 2021 (including 187 000 people with HIV). Worldwide, TB is the 13th leading cause of death and the second leading infectious killer after COVID-19 (above HIV/AIDS)
    • TB is preventable and curable and around 85% of people who develop the disease can be successfully treated with a 4/6-month drug regimen.
    • India accounts for more than a quarter of the total TB cases across the world.
    • According to India TB report 2023: Year 2022 saw notification of 24.2 lakh cases which was an increase of 13%over 2021.
    • Global Tuberculosis Report 2022
    •  World Health Organization released its 2022 version of the Global TB report.  
      • It provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease, at global, regional and country levels.   
    • Highlights Of the Report:
      • Increase in cases: An estimated 10.6 million people fell ill with tuberculosis (TB) in 2021, an increase of 4.5% from 2020 and 1.6 million people died from TB (including 1,87,000 among HIV positive people).
      • Country wise assessment: With 28% cases, India was among the eight countries accounting for more than two-third (or 68.3%) of the total TB patients’ count.
        • The other countries were Indonesia (9.2% cases), China (7.4%), the Philippines (7%), Pakistan (5.8%), Nigeria (4.4%), Bangladesh (3.6%) and the Democratic Republic of the Congo (2.9%).
      • The burden of drug-resistant TB (DR-TB):It also increased by 3% between 2020 and 2021, with 4, 50,000 new cases of rifampicin-resistant TB (RR-TB) in 2021.
        • This is the first time in many years that an increase has been reported in the number of people falling ill with TB and drug resistant TB.
      • Lack of Diagnosis: Continued challenges with providing and accessing essential TB services have meant that many people with TB were not diagnosed and treated. Underreporting is still a big concern globally. 
      • Global Issues : Ongoing conflicts across Eastern Europe, Africa and the Middle East have further exacerbated the situation for vulnerable populations.
        • Nearly 82% of global TB deaths among HIV-negative people occurred in the African and South-East Asia regions, with India alone accounting for 36% of such deaths.

    Government Initiatives

    • The government has started utilising technology by creating digital health IDs for TB patients under the Ayushman Bharat Digital Health Mission to ensure proper diagnostics and treatment.
    • Ni-kshay Poshan Yojana provides monetary support through direct benefit transfer to the patients.
    • National TB Elimination Programme to meet the goal of ending the TB epidemic by 2025 the country, five years ahead of the Sustainable Development Goals (SDG) for 2030
    • Pradhan Mantri TB Mukt Bharat Abhiyan: It’s an initiative of Ministry of Health and Family Welfare (MOHFW) to accelerate the country’s progress towards TB elimination by 2025.it provides additional patient support to improve treatment outcomes of TB patients.
    • TB Mukt Gram Panchayat Abhiyaan: TB Mukt Gram Panchayat campaign aims to involve the community  to realise the goal of TB elimination.it provides for TB Champions who have been identified and sensitised on TB at the Panchayat level .
    • Inclusion of Bacillus Calmette–Guérin (BCG) vaccine in the Indradhanush program.
    • Two vaccines VPM (Vaccine Projekt Management) 1002 and MIP (Mycobacterium Indicus Pranii) have been developed and are under  clinical trials.
    • Tuberculosis Model:India has developed a mathematical model for better estimation of the disease 
      • Using Using this model, TB incidence and mortality estimate data for India will be available by March every year, months before the annual WHO estimates .India can also prepare similar estimates at the state level using the model in future

    Challenges

    • Undernutrition : Data by various agencies observes that about 16.4 per cent of India’s population is poor, out of which 4.2 per cent live in extreme poverty as their deprivation score is more than 50 per cent. Poverty is associated with problems of undernourishment and poor and unhygienic living
    • Underreporting: One of the major factors of TB prevalence in India is under-reporting of TB cases. This leads to the risk of spreading TB to other healthy individuals.
    • Treatment: Inequitable access to quality diagnosis and treatment remains a major issue in combating tuberculosis. Further, the private sector which contributes a major part of TB care is fragmented, made up of diverse types of healthcare providers, and largely unregulated
    • Drug resistance to TB: Standard TB treatment is not followed uniformly across the private sector, resulting in the rise of drug resistance
    • Issues with RNCTP: Weak implementation of Revised National TB control program at state level is another major concern.
    • Social Stigma: Patients often hesitate to seek treatment or deny their condition altogether for fear of social discrimination and stigmatisation.

    Way forward:

    • India needs to follow a Multi pronged approach with focus on developing vaccines and incorporating technology and community efforts into TB treatment Regimen.

    Tuberculosis

    • TB is caused by a bacterium called Mycobacterium tuberculosis. In humans, TB most commonly affects the lungs (pulmonary TB), but it can also affect other organs (extra-pulmonary TB).
    • TB is spread from person to person through the air. Its common symptoms are cough with sputum and blood at times, chest pains, weakness, weight loss, fever and night sweats.
    • Most people who develop the disease are adults.
      • In 2021, men accounted for 56.5% of the TB burden, adult women (32.5%) and children (11%). 
      • Many new cases of TB are attributable to five risk factors: 
        • Undernutrition
        • HIV infection
        • Alcohol use disorders
        • Smoking
        • Diabetes. 
    • TB is preventable and curable and around 85% of people who develop the disease can be successfully treated with a 4/6-month drug regimen. 
      • Treatment has also the added benefit of curtailing onward transmission of infection. While TB is detected in every part of the world, 30 countries carry the highest burden. 
    • World Tuberculosis (TB) Day is observed on 24th March to spread awareness about the disastrous health, social, and economic consequences of TB and to take efforts to end the TB epidemic globally.
    • It was on this day that Dr. Robert Koch announced the discovery of a Mycobacterium tuberculosis that causes TB and his discovery opened the way towards diagnosing and curing this disease.

    Source: IE