Integrate TB services with primary health system: Lancet

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Headline : Integrate TB services with primary health system: Lancet

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The News

  • According to a study by Lancet, India is not on track to eliminate TB by 2025.
  • The article summarizes challenges identified in elimination of TB in India and solutions thereof as recommended by Lancet.

 

In focus: TB Elimination Report Card

Challenges to TB Elimination

High incidence

  • India is contributed about 27% of the 10.4 Million global TB incidences in 2017.

Marginal decrease

  • In ‘End TB Summit’, 2018, India set to eliminate TB incidence by 2025.
  • However the reduction in the number of TB cases is marginal, 2.79 million in 2016 to 2.74 million in 2017.
  • In order to eliminate TB, India needs to reduce incidence by 57% of 2015 level which is achievable only by 2035 (based on estimates)

Diagnostic delays

  • According to estimated the average time between infection and reporting for care is 4.1 months.
  • This is because of low level of case notifications (0.54 million in 2017) by the private sector. (25% of the target 2 million by 2020)

Economic burden

  • The monetary value of financial loss linked to TB mortality is estimated to be $32 billion per year in India.

Low spending

  • India is spending about ₹4,000 crore for tackling TB, but the report says this is not enough.

 

Solutions

Focus on prevention

  • Prevention measures at the population level.

Decentralise Diagnostics

  • Integrating TBV services with PHC (primary health care) network will reduce diagnostic delays.
  • Further conduct case-finding campaigns for early detection and diagnosis.

Private sector engagement

  • In order to strengthen access to TB services private sector engagement is necessary.
  • India has set a target of case notification by private sector to 2 million by 2020 in National Strategic Plan for TB Elimination.

Increase spending

  • India should increase spending on TB elimination by 400% in the next 5 years.
  • Subsidised tests and treatment can reduce mortality by 28% saving 80 lakh lives.

Universal Access

  • Universal access to drug susceptibility testing and second line TB drugs

 

Conclusion

  • With the aforesaid measures in order to strengthen the care cascade could reduce cumulative TB incidence by 38% in India.

Note: In an earlier article we have extensively covered on disease TB, treatment, situation in India and strategy adopted for TB elimination.

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