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A real shot at ending TB

Saurabh Gupta | Updated on September 05, 2021

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Saurabh Gupta

Fighting gear from the Covid-19 battle can be further deployed to defeat an old foe

No one in their living memory will forget this summer. The loss of life was huge and the pressure on our healthcare system, unprecedented. With the dust of the second Covid-19 wave settling, it’s time to reflect and act. Covid-19 blurred all other priorities on our healthcare agenda. But data can help us reorient.

India lost an estimated 4,39,895 lives to Covid-19 in over one-and-a-half years. Tuberculosis (TB) took 4,45,000 lives in just one year (2019 data — World Health Organization TB report 2020). This may look like an unbelievable statistic because most of us never paid attention to it. It is puzzling why India has not defeated TB despite it being less infectious.

With TB, early diagnosis helps in the treatment and containment of the spread. Chest X-rays and RT-PCR tests are reliable methods to detect TB and MDR (drug-resistant TB). India had a scarcity of both, especially outside urban centres.

The PCR machines available for the TB programme have low throughput (need more than 5 lakh hours of trained technicians to detect 26 lakh annual cases). The cost of deploying and using X-ray machines is even more prohibitive. Therefore, the National TB Control Programme’s target to reduce 90 per cent TB deaths by 2030 looked steep.

But now, India has a real shot at it. We can eradicate TB ahead of target if we leverage the ecosystem developed for Covid-19. India now has over 3,000 private and public labs with high throughput RT-PCR to process more than two lakh samples per day.

The cost of RT-PCR testing kits has reduced by 70 per cent with the emergence of a supplier ecosystem of raw material and kits.

Technicians to run molecular tests (RT-PCR) are no longer scarce. Indigenous players are developing combined tests for TB and Covid-19, making it twice as beneficial. A survey published in the BMJ in November 2020 showed 80 per cent with TB do not turn up for testing. We can use mobile RT-PCR testing labs developed during the pandemic to reach such patients.

Decades of practical learning got compressed into one year for our healthcare systems during the pandemic. There’s no time to waste. Let’s use these learnings to overcome TB, and let’s believe we can.

Saurabh Gupta is an independent data researcher. Views are personal

Published on September 05, 2021

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