Step Up for TB 2020 Report

• 18 Nov 2020

Why in News

The “Step Up for TB 2020” report by the Stop TB Partnership and Médecins Sans Frontières/Doctors Without Borders (MSF) has highlighted India’s conservative approach regarding the new medicines for Drug Resistant TB, putting lives of patients including children in danger.

• The current Pandemic has further aggravated the sufferings of TB patients in the country in terms of disease diagnosis, surveillance and treatment.

Note

• Founded in 1971, Médecins Sans Frontières (MSF), sometimes rendered in English as Doctors Without Borders, is an international humanitarian medical non-governmental organisation (NGO) of French origin best known for its projects in conflict zones and in countries affected by endemic diseases.
• It was awarded the Nobel Peace Prize in 1999.

Tuberculosis (TB)

• Tuberculosis is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs.
• Transmission: TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air.
• Symptoms: Cough with sputum and blood at times, chest pains, weakness, weight loss, fever and night sweats.
• Treatment: TB is treatable and curable disease.It is treated with a standard 6 month course of 4 antimicrobial drugs that are provided with information, supervision and support to the patient by a health worker or trained volunteer.
• Multidrug-resistant tuberculosis (MDR-TB) is a form of TB caused by bacteria that do not respond to isoniazid and rifampicin, the 2 most powerful, first-line anti-TB drugs. MDR-TB is treatable and curable by using second-line drugs.
• Extensively drug-resistant TB (XDR-TB) is a more serious form of MDR-TB caused by bacteria that do not respond to the most effective second-line anti-TB drugs, often leaving patients without any further treatment options.
• Tuberculosis (TB) remains the world’s deadliest infectious disease, killing more than 1.4 million people in 2019, despite being curable.

Key Points

• About the Report:
  
  • The report presents data on 37 high-burden countries, including India (representing 77% of the global estimated TB incident cases), assessing the extent to which national policies align with international best practices based on World Health Organisation (WHO) guidelines and the latest scientific research.
  • This is the 4^th edition of this report, which focuses on countries’ policies and practices related to 4 key areas of national TB programmes (NTPs):
    
    • Diagnosis,
    • Treatment (including models of care),
    • Prevention, and
    • Medicines procurement policies.
• Findings:
  
  • There are barriers to policy adoption and implementation across the surveyed countries.
  • The critical medical innovations are reaching very few people who urgently need them.
  • The report emphasised that oral treatment regimens for people with drug-resistant TB (DR-TB) must be prioritised over older, toxic drugs that have to be injected and cause serious side effects.
  • Nearly 1 in 3 people with TB disease is still not diagnosed and notified.
  • Almost 2 in 3 countries surveyed still do not include in their policies urinary TB lipoarabinomannan (TB LAM) testing for people living with HIV.
    
    • TB LAM is the only rapid point-of-care TB test available, and there is more than enough evidence of its benefits as a lifesaving point-of-care test.
• India Specific Findings:
  
  • India was criticised for not scaling up the new Disease Resistant (DR)-TB drugs Bedaquiline and Delamanid, needed even more during Covid-19.
    
    • Pretomanid is the third new drug developed for the treatment.
  • Until March 2020, less than 10% of India’s MDR-TB patients who were eligible for Bedaquiline had received it. This is alarming, since India is home to a quarter of the world’s DR-TB patients.
    • India has the highest TB burden in the world. In 2018, 2.15 million TB cases were reported, which is 16% more than in 2017.
• India’s Initiative to Fight TB:
  
  • National Tuberculosis Elimination Programme:
    
    • To align with the ambitious goal, the programme has been renamed from the Revised National Tuberculosis Control Programme (RNTCP) to National Tuberculosis Elimination Programme (NTEP).
  • Eliminating TB by 2025: India is committed to eliminating tuberculosis from the country by 2025, five years ahead of the global target by the World Health Organisation (WHO) i.e. 2030.
  • The Nikshay Ecosystem:
    
    • It is the National TB information system which is a one-stop solution to manage information of patients and monitor program activity and performance throughout the country.
  • Nikshay Poshan Yojana (NPY):
    
    • This scheme is aimed at providing financial support to TB patients for their nutrition.
  • TB Harega Desh Jeetega Campaign:
    
    • Launched In September 2019 it is showcasing the highest level of commitment for the elimination of TB.
  • The Saksham Project:
    
    • It is a project of the Tata Institute of Social Sciences (TISS) that has been providing psycho-social counselling to DR-TB patients.
  • The Government of India has partnered with the Global Fund to launch JEET (Joint Effort for Elimination of TB), a private sector engagement program operating across the country.
• Global Efforts:
  
  • The World Health Organization (WHO) has launched a joint initiative “Find. Treat. All. #EndTB” with the Global Fund and Stop TB Partnership.
    
    • The WHO End TB Strategy outlines global impact targets to reduce TB deaths by 90%, to cut new cases by 80% between the years 2015 and 2030, and to ensure that no family is burdened with catastrophic costs due to TB.
  • It aims to accelerate the TB response and ensure access to care, in line with WHO’s overall drive towards Universal Health Coverage.
• WHO also releases the Global Tuberculosis Report.

Way Forward

• Despite the notable successes achieved by the different programmes, robust efforts are needed to improve the early and accurate diagnosis followed by a prompt appropriate treatment which is vital for ending TB.
• India must collaborate with global efforts which are being done to eliminate the TB along with the paradigm shift in the control measure.

Source:IE