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On the upcoming World Tuberculosis Day (March 24), we will be just about 1,000 days away from the goal of eliminating TB by 2025.
After the pandemic derailed some TB control efforts, India made a good comeback. The number of notified TB cases which had declined by almost 25 percent in 2020, scaled back to pre-covid levels. In 2022, India published its first national TB prevalence survey after 1958. From this gigantic study led by NIRT Chennai, we learned that India’s adjusted TB prevalence rate stands at 312 per 1,00,000 people- close to 44 lakh patients.
Reading it with 24 lakh new TB notifications in 2022 and an incidence rate of 188 cases per lakh population (per WHO estimate in 2020), it is clear that India has both a stock and flow problem, ie, we have many people affected with TB and more are getting added every year.
In the national strategic plan to eliminate TB 2020-2025, the real goal is not to bring the incidence rate from 188 to zero by 2025, but reduce it — in the best-case scenario to 44, in the moderate case to 148, and in the lowest case to 170. Looking at what we have achieved until now, India seems to be closer to the moderate case scenario.
TB notifications in 2022 were 24 lakh, narrowly missing the moderate case target of 26 lakh notifications. In 2021, 36 lakh molecular tests were done, landing above the moderate case target. Treatment rates were also good with 95 percent of notified patients starting treatment and 83 percent successfully completing it. One aspect where we lagged is preventive treatment. For example, only 1.2 lakh household contacts with active TB cases were put on preventive therapy in 2021 against the target of 15 lakh household contacts.
Most indicators of prevent-detect-treat strategy show that progress has been made. The Nikshay Mitra program and TB Mukt Bharat Abhiyaan by the government are great ways to engage masses and the corporate sector in TB elimination efforts. Innovations by healthcare companies of new and improved molecular tests, AI-based radiology solutions, better drugs with shorter courses, and new vaccines have reached or are about to reach market.
India is progressing well, but we are far from the best-case scenario and need to run the next 1,000 days more like a sprint and less like a marathon.
The writer is Head of Impact Projects at Mylab Discovery Solutions. Views are personal
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