UPSC Daily Editorial Analysis | Controlling TB | 6 July 2022

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What the article is about?

  • Talks about the deficiencies of RNTCP and way ahead.

Syllabus: GS-II Health, Social Justice

Tuberculosis:

  • TB is caused by a bacterium called Mycobacterium tuberculosis, belonging to the Mycobacteriaceae family consisting of about 200 members.
  • In 2019, MDR-TB remained a public health crisis and a health security threat.
    • MultiDrug Resistant Tuberculosis (MDR-TB) is a strain of TB that cannot be treated with the two most powerful first-line treatment anti-TB drugs.
    • Extensively Drug Resistant Tuberculosis (XDR-TB) is a form of TB caused by bacteria that are resistant to several of the most effective anti-TB drugs.
  • Tuberculosis is the worst among endemic diseases, killing 1.5 million people every year (WHO).
    • In India, the TB capital of the world, the disease kills some 1,400 persons every day.
    • The National TB Control Programme of 1962 was a district-based one with public-private participation.
    • WHO experts, without factoring in the differences between the TB epidemiology of poor and rich countries, used a theoretical construct of TB control to design RNTCP. 

Flaws in the programme:

  • First, for a programme that is heavily funded by the government, there is no prescribed method of monitoring the trajectory of TB control.
  • Second, the assumption that treating pulmonary TB patients alone would control TB was epidemiologically fallacious in India.
    • HIV infection, diabetes, undernutrition, lung damage due to pollution, tobacco smoking, fall in immune functions due to chronic diseases, alcoholism, etc. accelerate reactivation TB.
  • Third, RNTCP has failed to elicit people’s partnership in TB control.
    • In India’s AIDS Control Programme, public education was given high priority.
    • Without people’s informed participation, stigma and delay in seeking help will continue. 

Way Ahead:

  • Realising that TB was not under control, WHO called for another programme revision through a World Health Assembly Resolu-tion in 2014 to eliminate TB by 2035.
  • Emboldened by the promise of an effective strategy, the Prime Minister announced in 2018 that India would eliminate TB by 2025.
  • As we have a huge backlog of latent TB, we cannot eliminate TB, but we must aim for a high level of control (lowering from 200 per lakh per year to 50 per lakh per year) and document it with measurement.
    • Trained State and District TB officers are already on the job and we have an extensive network of TB clinics and an army of community and field workers.
  • Once the deficiencies listed above are corrected, we can control TB. 



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