India’s Tuberculosis (TB) crisis

Despite the government’s commitment to “eliminate high-burden infectious” TB by 2025, ‘India is still far from reaching its goal’. There are six key challenges identified: TB diagnosis and access; lack of access to free, quality treatment and drugs; adequate nutrition and mental health support; stigma-free and gender responsive care; economic support; and high quality care.                                                                                                                                                  

1: Dimension- Barriers in India’s progress in combating TB

• Insufficient diagnosis and treatment access, stigma, and socioeconomic barriers continue to impede India’s progress in combating this disease.
• Poverty:Socioeconomic conditions create vulnerabilities to the disease.
• Undernutrition: It is a major risk factor for both the occurrence of new cases and the occurrence of severe TB that can result in TB deaths.
• Delayed diagnosis, and a lack of access to quality care. 
• Multi-drug resistance worsens matters.

2: Dimension- The right healthcare intervention

• Comprehensive care for children: Children constitute 6–7% of all patients treated under the national TB elimination programme
• Focus on nutrition: The state should immediately focus on increasing the duration and quality of inpatient care, particularly for very severe undernutrition.
• Effective diagnosis: There is a need to expand diagnostic facilities, include mobile testing units, improve access to molecular testing at affordable prices, and provide quick and accurate results.
• Addressing social factors: There is a need to address the social factors that aggravate the infection (poverty, stigma, etc).

Tamil Nadu Case Study (state-wide differentiated TB care model)

• The first published report?of a state-wide differentiated TB care model in Tamil Nadu (TN-KET), in 2023, showed that to reduce TB deaths in resource-limited settings, triaging — quickly examining patients to decide who is most seriously ill and must be treated first — can identify those with the immediate need for comprehensive assessment and inpatient care.
• Considering 70% of TB deaths happen within the first two months, it is important to triage patients at TB diagnosis.