Why is it in the News?

According to the Global TB Report 2023 by the World Health Organisation, India had the highest number of Tuberculosis (TB) cases in the world in 2022.

What is the Global Tuberculosis Report?

• The Global Tuberculosis Report published by the World Health Organisation (WHO).
• It provides a comprehensive and up-to-date assessment of the TB epidemic and progress in prevention, diagnosis, and treatment of the disease at global, regional, and country levels.
• This is done in the context of global TB commitments, strategies, and targets.
• This report is based primarily on data gathered by WHO from national ministries of health in annual rounds of data collection.

Key Findings of the Global Tuberculosis Report 2023?

• India had the highest number of Tuberculosis (TB) cases in the world in 2022.
• The country accounted for 27 percent of the total TB cases in the world.
• The report revealed that 30 nations accounted for 87 percent of the world's TB cases. 
• India was followed by Indonesia (10 per cent), China (7.1 per cent), the Philippines (7.0 per cent), Pakistan (5.7 per cent), Nigeria (4.5 per cent), Bangladesh (3.6 per cent), and the Democratic Republic of Congo (3.0 per cent).
• In the Case of the Fatality Ratio (the measure of how severe a disease is), India stood at 12 percent, which means 12 out of 100 patients died of the disease.
• Singapore had the lowest score of 1 percent while China stood at the 14th spot with 4 percent.
• While TB is curable, death can occur when it is diagnosed late.
• The report also highlights a recovery trend in TB diagnosis and treatment services in 2022, signaling a potential reversal of the COVID-19 impact on TB control efforts. 

What is Tuberculosis (TB)?

• Tuberculosis (TB) is an infectious disease primarily caused by the bacterium Mycobacterium tuberculosis.
• It mainly affects the lungs but can also impact other parts of the body such as the pleura (lining around the lungs), lymph nodes, intestines, spine, and brain.
• Transmission:
• TB spreads through the air when an infected person with active TB disease coughs, sneezes, or even talks.
• The bacteria can travel through the air and be inhaled by people who are nearby.
• Symptoms:
• Common symptoms include a persistent cough lasting three weeks or more, chest pain, unintentional weight loss, fatigue, and fever.
• The symptoms may develop gradually, making early detection crucial.
• Treatment for TB:
• TB is treated with a course of antibiotics, typically lasting six to nine months.
• It's crucial to complete the full course to ensure the bacteria are completely eradicated and to prevent drug resistance.
• Prevention:
• Prevention involves vaccination with the Bacillus Calmette-Guérin (BCG) vaccine, particularly in regions with high TB prevalence.
• Avoiding close contact with infected individuals helps prevent transmission.
• Drug-resistant TB:
• Drug-resistant TB occurs when the TB bacteria in a person's body don't respond to, or are resistant to, one or more of the primary TB drugs.
• There are two main categories of drug-resistant TB:
• MDR (multidrug-resistant) TB and
• XDR (extensively drug-resistant) TB.
• MDR TB is characterized by bacteria resistant to at least two vital TB drugs, isoniazid and rifampicin. These drugs are among the most effective in treating TB.
• On the other hand, XDR TB takes resistance a step further. In addition to being resistant to isoniazid and rifampicin, XDR TB strains are also resistant to any fluoroquinolone and at least one of three injectable second-line drugs: amikacin, kanamycin, or capreomycin.
• This makes XDR TB more challenging to treat, as it doesn't respond to a broader range of medications commonly used against TB.
• The World Health Organization's END TB Strategy, initiated in 2014, sets a goal to globally eradicate the TB epidemic by 2035.
• The strategy targets a 95% reduction in TB-related deaths compared to 2015, a 90% decrease in TB incidence rates by 2035 compared to 2015, and the ambitious aim of ensuring that no families face catastrophic costs due to TB by the year 2035.

Global Initiatives to Combat Tuberculosis:

• The World Health Organization (WHO), in collaboration with the Global Fund and Stop TB Partnership, has introduced the joint initiative "Find. Treat. All. #EndTB."
• The release of the Global Tuberculosis Report by WHO serves as a crucial tool in assessing and addressing the global TB situation.

Initiative by Government of India to Tackle Tuberculosis:

• National TB Elimination Programme: Prioritizing TB elimination by allocating additional resources under the National Health Mission, intensifying efforts towards achieving the goal of a TB-free India.
• Ayushman Bharat Digital Health Mission: It emphasizes the integration of technology by introducing digital health IDs for TB patients.
• This initiative aims to guarantee the availability of accurate diagnostics and appropriate treatment through digital means.
• Pradhan Mantri TB Mukt Bharat Abhiyan: It's an initiative of the Ministry of Health and Family Welfare (MOHFW) to accelerate the country’s progress towards TB elimination by 2025.
• Ni-kshay Poshan Yojana: It provides Rs 500 support through direct benefit transfer to eligible patients.
• Currently, two vaccines VPM (Vaccine Projekt Management) 1002 and MIP (Mycobacterium Indicus Pranii) have been developed and identified for TB, and are under Phase-3 clinical trial.

Way Forward

• Specialized Active Case Finding Drives: Launch targeted campaigns to actively identify and diagnose TB cases in specific populations.
• Scaling Up of Molecular Diagnostics to Block Levels: Expanding the use of molecular diagnostic techniques to the grassroots level for efficient and accurate TB detection.
• Decentralization of Screening Services through Ayushman Bharat Health & Wellness Centres: Extending screening services to local health and wellness centers under the Ayushman Bharat initiative, making TB detection more accessible.
• Private Sector Engagement: Collaborating with the private sector to enhance TB case identification and treatment.
• Newer Patient-Centric Initiatives: Introducing innovative models like the Family Caregiver Model and Differentiated Care to reduce mortality and improve treatment success rates.