Elemnating TB

 With the availability of game-changing new treatments, India must recast its TB-elimination programmes

tuberculosis (TB)

 1 India bears over a quarter of the global TB burden. 

2 Political will in India 

in 2023, addressing the big challenge of ‘missed’ TB cases, 25.1 lakh patients were diagnosed in India as having TB, 

3 the Prime Minister has urged citizens

 to work towards TB elimination — we must look to innovate and deploy proven technologies and tools at our disposal.

Regimens and issues

drug-resistant TB

 1 It has been encouraging to learn that India will soon introduce the World Health Organization (WHO)-recommended shorter regimen for drug-resistant TB. 

2 The current regimens 

on offer are long and arduous, requiring patients to consume nearly 13 to 14 tablets every day if they are on the shorter nine to 11-month regimen, or four to five tablets every day if they have been put on the 18 to 24 month longer regimen / set of rules.

3 it  has severe side effects, such as loss of hearing, and even psychosis.

4 it requires regular visits to a TB clinic for nearly two years is loss of employment, driving many families into poverty.

But In 2022, WHO recommended 

1 the shorter, safer and more effective regimens called BPaL/M for all drug-resistant TB patients.

2 there is a lot of recent data that show this regimen to be more effective with better compliance. 

3 With only three to four tablets every day, patients can complete their treatment within six months, with minimal side effects. 

4 The success rates of this regimen are also reported to be higher — 89% as compared to the 68% treatment success rate reported in the country in the 2023 India TB Report.

5 Given its efficacy, close to 80 countries around the world have already procured the BPaL/M regimen and about 20 of the highest burden countries are already rolling it out.

क्या क्या फ़ायदा हो सकता है ?

savings from implementing this regimen 

will be between 40% to 90% of the cost of current treatment regimens, and that an immediate transition to BPaL/M could result in an annual saving of approximately $740 million (or approximately ₹6,180 crore) for health systems globally. 

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Making the best use of new treatments

How do we go about diagnosing more people with TB ?

1 quick screening 

answer lies in making sure that we are screening and testing quickly and efficiently to reduce delays in accurate diagnosis. 

2 proactive approach is essential

 It is time we 

• modernised and used health datasets, 
• which include GIS mapping, 
•  identify vulnerable populations such as those with comorbidities (for example, malnutrition, diabetes and HIV), former COVID-19 patients, and at-risk communities in slums, prisons, or those who are homeless. 

3 Targeted multi-disease focused screening drives 

can then be conducted to detect TB cases early, even among those without typical symptoms.

4 In fact, recent evidence highlights that a significant number of people with pulmonary (i.e., lung) TB may not exhibit recognisable symptoms such as cough, fever, weight loss, or night sweats. 

5 Chest x-ray

The National TB Prevalence Survey (2019-21) highlights the importance of chest X-rays, which detected 42.6% of cases that would have otherwise been missed. 

Leveraging advancements in technology, portable X-ray machines equipped  with AI-driven tools can significantly reduce diagnostic delays, especially in remote and under-resourced areas.

6 rapid molecular test

Further, there is a critical need to expand the use of rapid molecular tests over less sensitive microscopy methods for faster detection and drug resistance profiling. 

Way forward

As we look to eliminate tuberculosis and and make our country TB-free, prioritising these essential areas will be critical as these will be an investment in a healthier future for all of us.

Source the hindu