Integrate TB services with primary health system
- Of the 10 million new tuberculosis (TB) cases reported globally in 2017 by the World Health Organisation, 2.74 million were from India, showing a marginal reduction from 2.79 million in 2016. Despite TB incidence in the country being 204 cases per 1,00,000 in 2017, the government has set a highly ambitious target of “eliminating TB by 2025”, five years ahead of the Sustainable Development Goals (SDGs) target.
- But according to The Lancet Global Health article based on modelling for three high-burden countries, including India, compared with 2015 data, 57% reduction in incidence and 72% reduction in mortality will been seen only by 2035. Strengthening the care cascade could reduce cumulative TB incidence by 38% in the case of India, it notes. India has to adopt measures to prevent TB on a population level to eliminate the disease in the coming decades,
- The India report card says diagnosis and treatment for drug-sensitive and drug-resistant TB need improvement. Modelling suggests that lives of eight million (28%) people with TB can be saved over the next 30 years if tests are subsidised and patients are supported to complete the treatment. “This would cost an extra $290 million each year, which is significantly less than India’s $32 billion losses associated with TB mortality each year,” it notes.
- The Lancet Commission recommends that India should scale up access to services for all those seeking them, optimise engagement of private sector providers and guarantee universal access to drug susceptibility testing and second line TB drugs.
“India has set an ambitious goal of eliminating TB by 2025, but integration of TB services with the primary health system to reduce diagnostic delays is not happening. Patients are not diagnosed and treated at the primary level, which is the first point of contact. Only this will lead to early diagnosis and help cut the transmission cycle,”