On World Tuberculosis (TB) Day 2018 (March 24), we find ourselves at a critical moment in the global fight against this curable and preventable infectious disease. We can find, cure and prevent TB on a global scale, but it will require more work, more science, more determination, and yes, more leaders if we are to end this epidemic.
That is why the theme for the World TB day is “wanted: Leaders for a TB free World”– is both timely and necessary.
Over the last 15 years, the number of TB deaths worldwide has fallen by 47 percent – that’s nearly 50 million lives saved since the year 2000 alone. And, while TB extracts a high economic price, efforts to end TB are one of the best public health investments – every dollar spent on TB results in a $43 economic benefit to society.
World TB Day 2018 is turning out to be special — never in the history of tuberculosis (TB) control has there been greater political attention and commitment to tackling the infectious disease that causes nearly two million deaths a year.
I was recently fortunate to be in New Delhi, where I witnessed Indian Prime Minister Sri Narendra Modi launch the TB Free India campaign at the Delhi End TB Summit.
In his opening speech, he declared that “India is determined to address the challenge of TB in mission mode. I am confident that India can be free of TB by 2025.”
India accounts for about a quarter of the global TB burden. Worldwide India is the country with the highest burden of both TB and MDR TB. India also has more than a million “missing” cases every year that are not notified and most remain either undiagnosed or unaccountably and inadequately diagnosed and treated in the private sector.
TB treatment & care in India is provided in the public sector by the government’s Revised National TB Control Programme (RNTCP) as well as through private sector health providers. The private sector is very large, and it is believed that more than half of all TB patients are cared for in the private sector.
The government is calling for the elimination of TB by 2025, and there is a new National Strategic Plan 2017 – 2025 with ambitious ideas endorsed by the government. One of the main changes, is that the emphasis is going to be on reaching patients seeking care from private providers. National Strategic Plan builds on the work already done with the new RNTCP operating guidelines. The RNTCP will also be helping private providers to provide quality care and treatment, rather than encouraging the private providers to send their patients to get care from the RNTCP. The NSP plans to provide incentives to private providers for following the standard protocols for diagnosis and treatment as well as for notifying the government of cases. Also patients referred to the government will receive a cash transfer to compensate them for the direct and indirect costs of undergoing treatment and as an incentive to complete treatment. This has already been trailed in some pilot projects.
With an aim to eradicate tuberculosis (TB) in India, the Centre has issued stringent rules. The Union Health Ministry has issued a notification stating that doctors, druggists, chemists and hospital authorities could face a jail term of six months to two years under the provisions of Sections 269 and 270. Section 269 states negligent act likely to spread infection of disease dangerous to life and IPC 270 states malignant act likely to spread infection of disease dangerous to life.
IPHA have MOU with THALI (Tuberculosis Health Active Learning Initiative) for notification and case management by the private practitioner.
I request all members and all branches to take active part in this ambitious goal and take leadership to bring all missing cases under treatment.
While the World has made progress against TB, we urgently do even more.
Dr Sanghamitra Ghosh
Secretary General, IPHA