Headline : Integrate TB services with primary health system: Lancet
Details :
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.
