Tuberculosis Elimination Strategy

[op-ed snap] The long fight against TB


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

From UPSC perspective, the following things are important:

Prelims level: Revised National TB Control Programme

Mains level: Drug resistance and TB


Rising incidence of TB in India

  1. The incidence rate of tuberculosis (TB) in India is estimated at 200-300 cases per 100,000 population per year
  2. As a comparison, in western Europe, it is five per 100,000 per year
  3. India’s estimated annual TB burden is 28 lakh, 27% of the global total
  4. Every day 1,200 Indians die of TB — 10 every three minutes
  5. Revised National TB Control Programme (RNTCP) has become a great humanitarian programme of free diagnosis and treatment instead of a control programme

Identification of TB

  1. Infection with TB bacilli is the necessary cause of TB
  2. Cough and blood in sputum occur only in lung TB
  3. Pelvic TB is the commonest cause of female infertility in India
  4. TB can affect the lungs, brain, bones, joints, the liver, intestines or for that matter any organ and can progress slowly or kill in weeks

Designing TB control

In designing TB control three processes must be understood: infection, progression, transmission

  1.  Infection occurs when TB bacilli are inhaled
  2. Progression occurs when bacilli become active, multiply and cause pathology
  3. Only when active TB affects the lungs do bacilli find an exit route to the atmosphere, necessary for transmission

Principles of control

  1. Beginning with schools, public education on TB and its prevention must replace ignorance and misconceptions
  2. No one should spit in public places and also practice cough and sneeze etiquette (covering one’s mouth and nose when coughing or sneezing)
  3. To block transmission, treatment should begin as soon as a symptom shows up

Way forward

  1. To outsmart TB bacilli, we must intercept infection, progression, and transmission
  2. Our only chance of victory is by the concerted use of all interventions — biomedical and socio-behavioral
  3. Any further delay may convert a controllable disease into an uncontrollable one, because of increasing frequency of resistance to drugs against TB
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