Community-wide screening must for TB elimination in India, says The Union president
J&K’s Budgam district and Lakshadweep (UT) were declared TB-free last year
New Delhi: The Indian government should invest in active TB case finding, community-wide screening, and extending financial and medical support to the communities to eliminate tuberculosis, Professor Guy Marks, president of The Union said.
Established in 1920, the International Union Against Tuberculosis and Lung Disease, or, The Union, is an NGO which works towards eradication of tuberculosis and lung diseases.
During a recent interaction held here, professor Marks said tuberculosis is one of the most infectious diseases that takes away 1.5 million lives every year and has been around for almost 10,000 years.
He said a big challenge lies in breaking the chain of its transmission because of its extremely infectious nature.
Since the latest COVID outbreak, the two decades of a slow decline in the number of deaths due to TB has been reversed, he said.
Throwing light on the problems standing in the way of TB elimination, Marks, also the Interim Executive Director of The Union, said, “TB is a public disease and not private because of being infectious. If you are a diabetic, it’s your problem because you can’t spread it to the community, but if you have TB, you can spread it across unknowingly because it is easily transmitted.”
Thus, this is the responsibility of society as a whole to work towards its elimination, he said.
“In the Indian setting, the government should invest in active TB case finding, screening everyone and extending financial and medical support to the communities to eliminate TB,” Marks said.
Talking about the solution, Dr Kuldeep Singh Sachdeva, Regional Director – The Union South-East Asia, observed, “What is missing in India is the process of ‘Home to test and Home to treat’, which can be carried out through hand-held devices like X-Ray machines.
“And the active case finding in communities, and identifying pockets where the number of cases is high, also may be instrumental towards the elimination of TB in India. Active case finding is very important as it helps in breaking the chain of transmission.”
Marks said there are so many barriers to TB elimination, such as political and communitarian barriers in high-burden settings, the stigma that comes with being infected by it, and insufficient recognition of the communal nature of airborne infectious diseases.
“We need to address the stigma of TB through community-wide education involving local thought leaders because people need to be aware that they are not only helping themselves but also helping their family, neighbours, workmates and community by preventing TB infection in others,” he said.
Elaborating on the causes of TB contraction, Dr Sachdeva said that malnourished people have 2-3 times more chances of being infected with TB.
Also, people with comorbidities like diabetes, damaged lungs, and HIV infection are vulnerable to TB infection, he said.
“Likewise, indoor air pollution and smoking increase 2-4 times chances of TB infection. These aspects also need to be addressed while talking about TB elimination,” Dr Sachdeva said.
Citing the World Health Organization (WHO) data, Dr Sachdeva said that over 4,100 people lose their lives to TB every day.
The Global TB Report 2021 estimates that with nearly 26 lakh TB cases, India has 26 percent of all global and multi-drug resistant TB cases, he said.
We have come a long way towards TB elimination in India as we have the tools of a drug, and diagnosis to eliminate TB, and over 90 percent of treatment for TB has been done.
Till 2009, it took 2-3 years for TB treatment, but now it takes only 6-9 months for the treatment. We have success stories of TB elimination in India as Lakshadweep (UT) and the district of Budgam (J&K) were declared TB-free last year,” Dr Sachdeva said.
