16-Dec-2022: Measures taken to reduce TB cases in India

The incidence of TB in India has reduced by 18% from 256/lakh population in 2015 to 210/lakh population in 2021. At the same time, the estimates of Drug Resistant TB in India have reduced by 20% from 1.49 lakh in 2015 to 1.19 lakh in 2021.

The following measures have been taken by the Government to reduce the number of TB and MDR-TB cases in the country:

1. The Government of India has developed a National Strategic Plan (2017-25) for Ending TB in the country by 2025.The key focus areas are:
   • Early diagnosis of all the TB patients, prompt treatment with quality assured drugs and treatment regimens along with suitable patient support systems to promote adherence.
   • Engaging with the patients seeking care in the private sector.
   • Prevention strategies including active case finding and contact tracing in high risk / vulnerable population
   • Airborne infection control.
   • Multi-sectoral response for addressing social determinants.
   • Availability of molecular diagnostics has been scaled up to 4761 machines covering all districts in the country. In addition, 79 Line Probe Assay labs and 96 liquid culture testing laboratories have been established in the country for diagnosis of MDR-TB and XDR-TB.
2. Universal Drug Susceptibility Testing (UDST) is implemented under the NTEP to ensure every diagnosed TB patient is tested to rule out drug resistance before or at the time of treatment initiation itself.
3. Newer drugs like Bedaquiline and Delamanid have also been made available for management of DRTB.
4. Decentralized DR TB treatment services are offered through 162 Nodal DR-TB Centres and 614 District DR TB centres across the country.
5. Pradhan Mantri TB Mukt Bharat Abhiyan (PMTBMBA):
   • Launched by the Ministry on 9th September 2022 for community support to TB patients with the objective to provide people with TB with additional nutritional, diagnostic and vocational support.
   • Nikshay 2.0 portal has been developed and made available in public domain for facilitating the community to register as Nikshay Mitra
   • Guidance documents have been developed and shared with all State/UTs to implement the initiative.
   • Periodic reviews are done to monitor the progress of the initiative at National and State/UT levels.

26-Nov-2022: Padma Shri, Khel Ratna Arjuna Awardee Dr. (h.c) Deepa Malik becomes Ni-Kshay Mitra and national ambassador for TB Mukt Bharat Campaign

Padma Shri, Khel Ratna Arjuna Awardee, India’s First Woman Paralympic Medalist and President of the Paralympic Committee of India, Dr. (h.c) Deepa Malik has pledged her support to the TB Mukt Bharat campaign by becoming its national ambassador and a Ni-Kshay Mitra.

Dr. (h.c) Deepa Malik expressed her commitment to the TB Mukt Bharat campaign, launched by Honorable Prime Minister Shri Narendra Modi in March 2018, when she participated in TB awareness activities at the Ministry of Health and Family Welfare Pavilion at the 41st India International Trade Fair at Pragati Maidan, New Delhi.

She further extended her support to the campaign by becoming a Ni-Kshay Mitra, an initiative launched by the Hon’ble President of India, Smt. Droupadi Murmu which strives to provide aid to TB afflicted patients on three levels of nutritional, additional diagnostic, and vocational support. She has adopted 5 TB patients herself as a Ni-Kshay Mitra and encouraged people to enroll in this scheme as well, highlighting that if everyone participates in their capacity by disbanding stigma, spreading awareness and providing aid, India will conquer TB very soon.

Speaking about her support for the TB Mukt Bharat campaign Dr. (h.c) Deepa Malik said: “I am delighted to join the TB Mukt Bharat Jan Andolan as a national ambassador and look forward to working with teams to amplify further much-needed awareness of this debilitating disease, which can be easily prevented and cured, to ensure India reaches its target to be TB Free by 2025!

She recounted her story of becoming a TB survivor, she emphasized that while the treatment is physical, the first step of recovery commences with mental well-being, focusing on maintaining a positive mindset and rising above the stigma surrounding this condition. She stressed that though journey to complete recovery may take time, it is crucial to perceive health holistically, extending beyond the physical aspect to include mental well-being as well. She highlighted that “health is the ultimate wealth”, urging participation in the Jan Andolan movement, contributing in building momentum to ensure India becomes free of TB by 2025.

“I firmly believe that no one should ever be left behind in fulfilling their potential because of their age, race, gender, or ability. This includes anyone suffering from a disease such as TB. They should never feel alone, and it is our duty as citizens to do whatever we can to support them. We must reach out to them as a Mitra and remind them they are supported, which is why I fully support the Ni-kshay Mitra initiative as a Ni-kshay Mitra myself”.

9-Sep-2022: President of India launches Pradhan Mantri TB Mukt Bharat Abhiyaan

The President of India, Smt Droupadi Murmu virtually launched the Pradhan Mantri TB Mukt Bharat Abhiyaan today (September 9, 2022).

Speaking on the occasion, the President said that it is the duty of all citizens to give high priority to 'Pradhan Mantri TB-Mukt Bharat Abhiyaan' and to make this campaign a mass movement. It is because TB causes the largest number of deaths among all other infectious diseases in our country. She noted that India has a little less than 20 percent of the world's population, but has more than 25 percent of the total TB patients of the world. This is a matter of concern. She also noted that most of the people affected by TB come from the poor section of society.

The President said that the thinking and methodology of ‘New India’ is to make India a leading nation of the world. India has set an example to the world in tackling the COVID-19 pandemic. The policy of ‘New India’ to move forward with confidence is also visible in the field of TB eradication. According to the United Nations Sustainable Development Goals, all nations have set the goal of eradicating TB by the year 2030. But the Government of India has set the target of eradicating TB by the year 2025 and efforts are being made at every level to fulfill this resolution.

The President said that to make this campaign a mass movement, awareness about TB has to be created among the people. They have to be informed that prevention of this disease is possible. Its treatment is effective and accessible and the government provides a free of cost facility for prevention and treatment of this disease. She said that in some patients or communities, there is an inferiority complex associated with this disease, and they view the disease as a stigma. This illusion also has to be eradicated. Everyone should be aware that TB germs are often present in everyone's body. When the immunity of a person, due to some reason, decreases, then this disease expresses in the person. With treatment, one can definitely get rid of this disease. All these things should reach the people. Then the people affected by TB will be able to take advantage of the treatment facilities.

The Pradhan Mantri TB Mukt Bharat Abhiyaan has been envisioned to bring together all community stakeholders to support those on TB treatment and accelerate the country’s progress towards TB elimination.

The virtual event was attended by Union Minister of Health and Family Welfare, Dr. Mansukh Mandaviya, Minister of State for Health and Family Welfare, Dr. Bharati Pravin Pawar, Governors and Lt. Governors of states and UTs, representatives from State and District Health Administration and other stakeholders.

13-Apr-2021: Dr Harsh Vardhan addresses Tuberculosis Technical Consultants Network

Dr Harsh Vardhan, Union Minister of Health and Family Welfare addressed the Tuberculosis Technical Consultants Network Teams comprised of WHO-National Professional Officers for TB and consultants from across the country through Video Conference, here today. He was joined by Dr Poonam Khetrapal Singh, Regional Director, WHO-SEARO, Dr Roderico Ofrin, WHO Representative to India.

At the outset, Dr Harsh Vardhan congratulated WHO for their continued support to India in its journey to eliminate TB by 2025. He thanked the organization for helping ICMR and the Indian Association of Preventive and Social Medicine in the recently conducted Sub-National Disease Certification. “We have now declared one UT, Lakshadweep and one District, Badgam in Jammu and Kashmir as TB free”, he stated.

Dr Harsh Vardhan also detailed how WHO has always been a constant source of transformative change in all health matters “Right from technical support, research, policy, monitoring and evaluation, capacity building to public health communication and knowledge dissemination, WHO have always been there to support us; be it in drawing up the National Health Policy, or in initiatives like Ayushman Bharat, strengthening primary care through Health & Wellness Centres or promotion of digital health.” In this context, he reminisced the fruitful collaboration he had with WHO as Delhi’s Health Minister and the exceptional role played by WHO in wiping out Polio myelitis from India which used to have 60% of the global case burden before 2009. India is polio free since 2011. He also further elaborated the support provided by WHO in the COVID crisis.

Highlighting the significant role the Consultant Network played under the National Tuberculosis Elimination Programme (NTEP) which has helped in reducing the gap of missing cases, and in achieving successful treatment outcomes, he said, “It is an encouraging sign and reflects that we are now able to provide better access for TB patients through our health sector (both public and private) and also reach out to communities through our Active Case Finding (ACF) drives, and provision of free treatment to TB patients. As proper diagnosis and prompt treatment are key to TB elimination, the consultant network must now focus on both detecting cases early and preventing the emergence of new cases.”

Dr Harsh Vardhan stressed on the need to create a scalable and replicable model at the earliest at the grassroots. He said, “The Success of the TB Jan Andolan solely depends on activities reaching grassroots populations. Action has to pivot around States and most importantly, in hard-to-reach areas. No two States are the same and we need to customize activities as per geography to accomplish a multiplier effect and bring in perceptible and measurable change.” He also noted that the time is ripe to build upon the work that WHO has been supporting for the last 70 years and expand the collaboration beyond medical interventions to include other Ministries, Gram Panchayats, and elected representatives.

He concluded his speech emphasizing that eliminating TB from India is not only important for this country, but has much deeper ramifications for the whole world and will considerably motivate smaller countries to this end.

He also expressed his unreserved thanks to every individual of the network working in different capacities on the ground at the level of villages, district and States, in hospitals and in research and implementation of policy for helping India fight TB and requested their full attention towards making the TB Jan-Andolan a success.

Dr Poonam Khetrapal Singh observed that India’s political commitment to end TB is reflected in the more than fourfold budget allocation for TB in the period 2016-2018 (from 105 million USD to 458 million USD). She also pointed out that this allocation ensured that the WHO Tuberculosis Consultants Network was not dependent on any other donor source for sustenance.

26-Mar-2021: Dr Harsh Vardhan launches Tribal TB Initiative in pursuit of ‘TB Mukt Bharat’

In fulfilment of the cherished goal of a “TB Mukt Bharat” envisioned by Prime Minister Shri Narendra Modi, Dr Harsh Vardhan, Union Minister for Health and Family Welfare today launched the “Tribal TB Initiative” along with Shri Arjun Munda, Union Minister for Tribal Affairs in the presence of Shri Ashwini Kumar Choubey, Minister of State for Health and Family Welfare. A Guidance Note on Joint Action Plan for Tuberculosis (TB) Elimination, a Special Edition of Tribal Ministry’s Publication ‘ALEKH’ on TB, and a document on Tribal Tuberculosis (TB) Initiative was also released at the event.

The Union Health Minister noted the topical need to organize the event. He highlighted that India witnessed over 18.04 lakh TB notifications, notwithstanding the difficulties presented because of the COVID-19 pandemic and its related regulation/preventive strategies.  “In spite of all the unforeseen challenges of COVID 19, the Government of India was able to convert all those into opportunities for TB Elimination by introducing bidirectional screening for COVID-19 and TB, strengthening diagnostic networks and combining TB screening in COVID surveillance activities’ he pointed out.  Health being a holistic subject influenced by all aspects of life, the necessity to have a multisectoral collaboration with various Ministries and Departments to reach out to the most vulnerable population categories was underscored to achieve the elimination target by 2025.

De Harsh Vardhan reiterated that the UT of Lakshadweep and district of Badgam in Jammu & Kashmir have been declared TB Free on World TB Day this year while several other States and Districts across the country have been awarded for their progress made towards achieving the SDGs related to TB. He added that, “This Government accords top priority to ensuring Universal Access to free treatment and care for TB across the country. In India, we have over 10 Cr tribal population living with a huge diversity in their population dynamics. Through constant efforts, our government is able to see developments in their health indicators and overall wellbeing. The government has already increased the Budget allocation for TB in India a four-fold in the last 5 years. High quality drugs, diagnostics, digital initiatives, innovative private sector interventions and community engagement intervention, are all aligned to rapidly decline TB incidence and mortality in the country.”

The Ministers were apprised that over 104 million tribal population lives in India, across 705 tribes, accounting for 8.6 % of the country’s population. 177 tribal districts were identified as high priority districts where physical remoteness, malnutrition, poor living conditions and lack of awareness contribute to the vulnerability of the tribal population to TB. Initially, the activities of the joint plan will be focusing on 161 districts across 18 identified States. They would involve deploying improved vulnerability mapping techniques, organization of sensitization and capacity building workshops for volunteers, periodic TB active case finding drives, provision of TB Preventive Therapy (IPT) to identified vulnerable population and develop long term mechanisms for vulnerability reduction.

The Union Health Minister mentioned that the linking of NIKSHAY Portal of MoHFW and Swasthya Portal of the M/o Tribal Affairs will help boost data compilation on TB and pave way for efficient and convergent actions. He said, “India will be the textbook guidance to the world in TB elimination, if we could achieve this by 2025, even before the global SDG target of 2030.”

Shri Arjun Munda, Union Minister for Tribal Affairs congratulated both the Ministries on the formulation of the joint plan and observed, “The health problems of the tribal communities need customised solutions. It is heartening to see the joint initiatives of both the Ministries to eliminate TB among the tribal communities of India. I hope that in the coming days, we are able to identify similar diseases which are widespread among the tribal communities, and devise mechanisms to curb their spread.”

Shri Ashwini Kumar Choubey spoke on the all-round initiatives undertaken by the government to ensure Health for all and thanked partner organizations like USAID, BMGF and Piramal Foundation for helping TB Care reach the last person in the remotest parts of the country.