Tuberculosis Elimination Strategy

[op-ed snap] Reaching the unreached: Tuberculosis


Mains Paper 2: Governance | Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

From UPSC perspective, the following things are important:

Prelims level: Read the attached stories for the particulars of the TB disease

Mains level: The newscard discusses the issue of non-reporting of TB cases and government steps against it.


Government action against non-reporting of TB cases

  1. The government has recently passed a gazette notification making the non-reporting of TB cases a punishable offence, with even a jail term of up to two years
  2. The move comes against the backdrop of the Prime Minister’s call to end TB in India by 2025, ushering in a ‘mission mode’ approach to defeat the disease

Non-reporting of TB cases in India

  1. A study in The Lancet in 2016 estimated that as many as 22 lakh cases of TB were treated in the private sector in 2014; in the public sector, the figure was 14 lakh
  2. Going by The Lancet ’s estimates, almost 19 lakh cases are still ‘missing’

What is the harm if a patient is not reported to the government and is being diagnosed and treated in the private sector? 

  1. First, not being reported to the government means the true burden of the disease remains unknown
  2. Second, the absence of drug distribution controls and poor treatment practices accentuate the emergence of drug-resistant TB
  3. Anti-TB drugs are widely available without prescription at numerous pharmacy outlets
  4. Also, limited usage of the Standards for TB Care in India (STCI), which are the standard protocols to be adhered by providers, leads to incorrect diagnosis and improper treatment
  5. This in turn delays the commencement of treatment and can even contribute to drug resistance
  6. Finally, TB is five times more common among the economically weaker sections of society and the disease can have devastating financial and social consequences

Steps taken by the government

  1. In order to address these issues, the government has proposed innovative measures which include a ‘direct benefit transfer’ for nutritional support and free diagnosis and treatment
    (particularly to patients being treated in the private sector)
  2. However, the first step in extending these support systems to all patients would be to correctly identify them


  1. A web-based application called ‘Nikshay’ was launched in 2012 to help providers notify cases to the authorities
  2. However, low awareness about this portal among private providers and technical difficulties in the software resulted in its low use
  3. Considering that punitive action can be taken against providers for not reporting cases

The way forward

  1. The notification policy, supplemented by
    (1) the comprehensive strengthening of the public health system,
    (2) greater engagement with the private sector,
    (3) the simplification of the reporting process and more awareness among public and health-care providers,
  2. is sure to reach the goal of a TB-free India
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