7.5 million New cases of TB in 2022: WHO Global TB Report

 The recently released WHO report pointed out the rise in new cases and some improvements in terms of recovery in the number of people diagnosed with TB and treated in 2022.

What are the observations?

• TB remains the world's second leading cause of death from a single infectious agent, with global targets off track. From 2015 to 2022, there was only an 8.7% reduction, falling far short of the 50% reduction goal by 2025 in the WHO End TB Strategy.
• In 2022, an estimated 1.30 million deaths were attributed to TB. Although two years of COVID-related disruptions occurred, there were some improvements in the number of people diagnosed and treated for TB in 2022.
• The global number of newly diagnosed TB cases in 2022, 7.5 million, is the highest since WHO began monitoring in 1995. India, Indonesia, and the Philippines accounted for nearly 60% of the reduction in newly diagnosed TB cases in 2020 and 2021.
• Silver linings: Success rate for treatment is-88% for people treated for drug-susceptible TB and 63% for people with MDR/RR-TB.

What is TB?

• TB, or tuberculosis, is a bacterial infection primarily caused by Mycobacterium tuberculosis. It mainly affects the lungs but can also affect other parts of the body.
• It spreads through the air when an infected person coughs or sneezes, and it's transmitted when someone inhales the bacteria.

Treatment

Tuberculosis (TB) treatment, the terms "first-line drugs," "second-line drugs," "MDR," and "XDR" refer to different categories of medications and levels of drug resistance:

• First-line drugs: primary antibiotics used in the initial treatment of drug-sensitive TB. They are highly effective, and most people can be cured with these drugs.
• Second-line drugs: used when TB bacteria become resistant to one or more of the first-line drugs, leading to a condition known as drug-resistant TB. They are used in the treatment of drug-resistant TB.
• MDR-TB (Multidrug-resistant TB): MDR-TB occurs when TB bacteria are resistant to at least two of the most potent first-line drugs, isoniazid and rifampin. It requires treatment with second-line drugs for an extended period.
• XDR-TB (Extensively Drug-Resistant TB): more severe form of drug-resistant TB. It involves resistance to not only isoniazid and rifampin but also to at least one fluoroquinolone and one of the three injectable second-line drugs (amikacin, kanamycin, or capreomycin). Treatment is more difficult and less successful than for MDR-TB.

WHO’s End TB Strategy

• WHO developed the End TB Strategy, which was endorsed by the Sixty-seventh World Health Assembly in 2014. It envisions a world free of TB, with zero deaths, disease and suffering due to the disease. It proposes to “end the global TB epidemic” by 2035.
• Built on three strategic pillars underpinned by four key principles focusing on government stewardship, a strong coalition made up of civil society and communities, promoting human rights and equity, and adaptation of the Strategy at the country level.

Measures to Eradicate TB in India:

National Tuberculosis Elimination Programme (NTEP): Aims to strategically reduce India's TB burden by 2025. Formerly known as the Revised National Tuberculosis Control Programme (RNTCP).

National Strategic Plan for TB Elimination: Launched with a mission to end TB by 2025. Focuses on detecting all TB patients, including those seeking care from private providers and high-risk populations.

Ni-kshay Poshan Yojana (NPY) - Nutritional Support to TB: Provides nutritional support to TB patients, particularly underserved individuals. Over Rs. 1,707 crore disbursed to more than 65 lakh TB patients since 2018.

Patient Provider Support Agencies (PPSA): Engage the private sector in TB care. Implemented in 250 districts through domestic setup and JEET initiative.

Universal Drug Susceptibility Testing (UDST): Ensures drug resistance testing for every diagnosed TB patient before or at the start of treatment.

Pradhan Mantri TB Mukt Bharat Abhiyaan: Mobilizes community stakeholders to support TB patients and accelerate India's progress towards TB elimination.

Ayushman Bharat - Health and Wellness Centres: Decentralizes comprehensive primary healthcare, including TB services, at the grassroots level.

Introduces newer drugs like Bedaquiline and Delamanid for the management of drug-resistant TB (DRTB).

The development of drug resistance in TB is a significant public health concern, and it highlights the importance of appropriate treatment, adherence to medication, and prevention strategies to control the spread of drug-resistant TB strains.