A new edge to the fight against tuberculosis

Source– The post is based on the article “A new edge to the fight against tuberculosis” published in “The Hindu” on 21st April 2023.

Syllabus: GS 2- Issues related to development and management of health

News – At the One World TB Summit in Varanasi, Prime Minister Narendra Modi instilled fresh energy to global tuberculosis (TB) elimination response and reiterated India’s commitment to spearhead this effort.

What is the progress of India in fighting against TB?

India’s National Tuberculosis Control Program has introduced several measures to find, notify and treat TB cases.

Case notifications have risen from 15.6 lakh in 2014 to over 24 lakh in 2022. This reflects the program’s expanded reach and improved detection measures.

Novel approaches have been introduced to fight TB. It includes engagement with the private sector, launch of social support provisions and introduction of diagnostic tools and new drug regimens. It has improved TB management.

What are challenges in the fight against TB?

There is a lack of widespread awareness about the disease and lack of access to quality care. The recent National TB Prevalence Survey found that 64% of people with infectious TB did not seek care.

National-level estimates suggest that for every person notified with TB, it misses detecting almost two more cases.

What is the way forward for elimination of TB in India?

There is a need to introduce disruptive approaches and new tools to change the way for preventing, diagnosing, and treating TB.

Vaccines– For any infectious disease, a vaccine is what makes elimination possible. The BCG vaccine for TB does not adequately protect adolescents and adults. There is a need to prioritise and pick up the pace to find an effective TB vaccine.

There are currently over 15 TB vaccine candidates in the pipeline. There is a need to ensure that their clinical trials are prioritised to assess their efficacy in various community settings and for different target groups.

Testing– Testing for, and diagnosing TB needs to become more accessible and affordable. Point-of-Care Tests such as home-based tests for COVID allow decentralised, rapid and low-cost diagnostics to provide results within minutes. New innovations such as nasal and tongue swab-based tests for TB can be a game changer.

Further, handheld digital x-ray machines can now be taken to villages and urban settlements to screen large numbers of high-risk individuals, safely and conveniently.

Drugs– The development and introduction of new therapeutic molecules can play a crucial role in the long run. There is a need to scale up newer and more effective regimens and repurpose existing drugs for TB.

Shorter, safer, and more effective regimens do exist. It includes the 1HP regimen for latent TB infections, the four-month regimen for drug-susceptible TB, and the six-month regimen for drug-resistant TB. These need to be scaled up.

Policy framework– There is a need to create regulatory and policy frameworks for smooth rollout of proven tools to reach people with little delay.

This requires greater collaboration between policymakers, scientists, product developers, clinical researchers and governments.

Harmonization of standards and regulatory processes between countries is important. It can enable mutual recognition of evidence-based standards and licenses.