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(Relevance: UPSC has asked questions related to health. In this regard, learning about the Global TB Report is important.)

According to the latest World Health Organization’s (WHO) Global Tuberculosis Report, while the estimated number of tuberculosis (TB) cases in India decreased slightly in 2023, the number of cases reported increased – a positive sign that the gaps in diagnosis are closing.

1. TB is caused by an organism called mycobacterium tuberculosis, which mainly affects the lungs, but can also impact other parts of the body. TB spreads through the air when an infected individual coughs, sneezes, or speaks.

2. Once diagnosed, the treatment depends on whether it is drug-resistant or simple tuberculosis. According to experts, when recovering from TB, it is critical to consume a well-balanced and nutritious diet to help strengthen the immune system.

3. According to the Global TB Report 2024, India saw a slight decline in the estimated number of tuberculosis cases and deaths in 2023, but it is nowhere near its elimination target. India had an estimated 28 lakh TB cases in 2023, accounting for 26% of the global cases. And, there were estimated 3.15 lakh TB-related deaths, accounting for 29% of the deaths globally.

4. The report also said the gap between the estimated number of cases and the number of people actually getting diagnosed has been closing. India reported 25.2 lakh cases in 2023, increasing from 24.2 lakh the previous year.  “The two countries that made the biggest contributions to the global rebound in the reported number of people newly diagnosed with TB in 2022 and 2023 were India and Indonesia, which together accounted for 45 per cent of the increase between 2021 and 2023,” the report said.

5. With this progress, India is not even close to the WHO End TB targets. There has been a decline of only 18 per cent in TB cases between 2015 and 2023 as against the target of 50 per cent by 2025. TB deaths have declined by 24 per cent as against a target of 75 per cent by 2025.

6. Globally, 82 lakh people were newly diagnosed with TB in 2023 – the highest number recorded since WHO began global TB monitoring in 1995 — making it the leading infectious killer again, surpassing Covid-19 in 2023.

7. The Global TB Report also highlights a massive funding gap, stating that only $ 5.7 billion of the $ 22 billion funding target was available in 2023.

 

8. The report shows that funding for TB in India has been shrinking. The total funding for TB reduced from $432.6 million in 2019 to $302.8 million in 2023. Domestic funding alone went down from $345.9 million to $253 million.

 

World Tuberculosis Day

In December 2022, WHO recommended the use of the BPaLM/BPaL regimen for Drug-resistant tuberculosis (DR-TB) patients, which offers a much higher success rate of 89 per cent.

Pretomanid (Pa) is used in combination with bedaquiline (B), linezolid (L) and sometimes moxifloxacin (M) to form BPaL and BPaLM. India is the only global supplier of pretomanid, a key drug within the BPaL regimen.

 

1. Although the elimination of tuberculosis is one of the sustainable development targets to be achieved by 2030 by the world, India has set a target for 2025. The national strategic plan 2017-2025 sets the target for India to report no more than 44 new TB cases or 65 total cases per lakh population by 2025.

2. India has ensured a treatment coverage of 85% and is among seven of the 30 high-burden countries with high treatment coverage. This is significant considering TB is the largest infectious killer and without treatment, it kills nearly half the people it infects. In India, the government offers free medicines for TB treatment, which is essential as the medicines can be expensive and the therapy may continue for as long as two years.

3. One of the big challenges with tuberculosis treatment is the long duration for which people have to continue taking their medicines. The government has been working on devising innovative ways to ensure compliance such as pill boxes that track and remind the patient to take medicine as well as introducing shorter courses of treatment.

4. An online Ni-kshay portal has been set up to track the notified TB cases. The government also launched a community engagement program where Ni-kshay Mitras can adopt TB patients and provide them with monthly nutritional support.

5. Newer drugs such as Bedaquiline and Delamanid for the treatment of drug-resistant TB have been included in the government’s basket of drugs provided to free TB patients.

 

(Source: Global TB report shows India continues to have highest disease burden, High TB treatment coverage in India, surge in preventive therapy: WHO report, World Tuberculosis Day )

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