“In 2020 India’s TB programme saw over 18.04 lakh TB notifications, despite the challenges posed due to the COVID-19 pandemic and its associated containment/preventive strategies. Encouragingly, post the lockdown period of April-June, by implementing several innovative strategies, we managed to bring the programme to pre-COVID levels and are back on track to ending TB by 2025, in line with the Hon’ble Prime Minister’s vision,” said Ms. Arti Ahuja, Additional Secretary, Ministry of Health and Family Welfare, New Delhi.
While the second quarter of 2020, April-June, saw a decline in TB notifications to 3.61 lakh, there were over 4.63 lakh notifications registered in the last quarter of 2020, October-December. These were due to a series of new initiatives implemented through the course of the year, keeping in mind fear and stigma among the population due to the common symptoms between COVID-19 and TB, and the diversion of human resources from the TB programme toward the COVID-19 response.
These initiatives included bi-directional screening of TB and COVID-19, expansion of private sector engagement programmes, active case finding exercises across all State/UTs, engagement with the community through the creation of state and district TB forums and providing door-step delivery of services including screening, diagnosis and treatment. The States came up with innovative strategies for transportation of sputum samples for diagnosing TB as well as the delivery of drugs to TB patients.
Moreover, indigenously developed cost-effective, point-of-care molecular diagnostic machines (called TrueNAT) were also deployed to test for both COVID-19 and TB across the country. Many State/UTs also leveraged the house-to-house COVID-19 screening campaigns and integrated TB as well in the COVID surveillance strategies.
In 2020, few states performed relatively better compared to other states, including Delhi, Himachal Pradesh and Telangana that were able to achieve over 75% of the target notifications set at the start of the year. States including Bihar, Karnataka and Tamil Nadu saw a significant fall in notifications and registered only around 50% of the target.
“In order to provide an impetus to our state and district officials, we have created incentive structures to award high-performing States and Districts that are moving toward their elimination targets. Up to now, 67 districts across 19 States have claimed success in significantly bringing down TB incidence in their regions” said Mr. Vikas Sheel, Joint Secretary, Ministry of Health and Family Welfare.
The Health Ministry also ensured the timely payment of incentive schemes such as the Nikshay Poshan Yojana to eligible beneficiaries. Since its launch in April 2018, the Nikshay Poshan Yojana (a Direct Benefit Transfer scheme for nutrition support to TB patients) has seen over Rs. 1,000 crores being disbursed to over 40 lakh patients. Alongside, over Rs. 30 crores have been disbursed as part of other incentive schemes to over 3 lakh private providers, treatment supporters and informants.
Other important initiatives launched include the setting up of State and District TB forums across the country. Till date, of the total 719 districts, 711 have active District TB Forums, with all constituted forums having conducted meetings in 2020. On similar lines, over 2,250 TB survivors have been trained as champions by central and state TB officials, who will in turn help the programme raise awareness among the community and support programme efforts to ensure all TB cases are notified to the programme and complete their treatment, as per protocols.
In November 2020, the Honourable Union Health Minister, Dr. Harsh Vardhan announced the launch of a TB Mukt Bharat Campaign for TB Elimination, to make TB a collective responsibility of the entire community, and create awareness about TB, and help de-stigmatize the disease.
“India has made significant strides in improving health indicators under the leadership of our Hon’ble Prime Minister, Shri Narendra Modi. These advances are unprecedented both in terms of their scale and reach and bear testimony to our sincere commitment towards a healthy and more productive India. But TB cannot be eliminated without the active participation of all stakeholders including the 140 crore citizens of this country. The TB Mukt Bharat campaign will strengthen on-ground programme delivery to generate demand and create awareness on the services available under the TB programme to make sure our country defeats this disease in the next four years” said the Honourable Union Health Minister.