{"id":34254,"date":"2018-10-30T16:32:45","date_gmt":"2018-10-30T11:02:45","guid":{"rendered":"https:\/\/blog.forumias.com\/?p=34254"},"modified":"2018-10-30T16:32:45","modified_gmt":"2018-10-30T11:02:45","slug":"threefold-rise-in-domestic-budget-for-fight-against-tuberculosis","status":"publish","type":"post","link":"https:\/\/forumias.com\/blog\/threefold-rise-in-domestic-budget-for-fight-against-tuberculosis\/","title":{"rendered":"Threefold rise in domestic budget for fight against tuberculosis:"},"content":{"rendered":"<p><a href=\"https:\/\/www.google.co.in\/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=1&amp;cad=rja&amp;uact=8&amp;ved=0ahUKEwi9tp-XwpzXAhWJvo8KHc2gDgQQqOcBCCUwAA&amp;url=http%3A%2F%2Fwww.thehindu.com%2Fnews%2Fnational%2Fthreefold-rise-in-domestic-budget-for-fight-against-tuberculosis%2Farticle19957049.ece&amp;usg=AOvVaw0Sm50iA-PSW0Lg0F3hXfcq\"><span style=\"font-weight: 400;\">Threefold rise in domestic budget for fight against tuberculosis<\/span><\/a><span style=\"font-weight: 400;\">:<\/span><\/p>\n<p><b>Context<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">According to a report from the <\/span><b>World Health Organisation (WHO)<\/b><span style=\"font-weight: 400;\">, India\u2019s <\/span><b>domestic budget<\/b><span style=\"font-weight: 400;\"> for fighting tuberculosis showed a dramatic jump from about <\/span><span style=\"font-weight: 400;\">\u20b9<\/span><span style=\"font-weight: 400;\">700 crores in 2015 to <\/span><span style=\"font-weight: 400;\">\u20b9<\/span><span style=\"font-weight: 400;\">2,500 crores last year.<\/span><\/li>\n<\/ul>\n<p><b>Why is it important?<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Most of India\u2019s budget to <\/span><b>combat the bacterial infection<\/b><span style=\"font-weight: 400;\"> use to be dominated by <\/span><b>international funding.<\/b><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">For the very first-time things have flipped as <\/span><b>domestic resources accounted for 74%<\/b><span style=\"font-weight: 400;\"> of the $525 million spent in India last year, while it was only 38% in 2015.<\/span><\/li>\n<\/ul>\n<p><b>Decrease in numbers<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">In 2016, <\/span><b>India recorded a 12% dip in the number of TB deaths<\/b><span style=\"font-weight: 400;\"> from the previous year though the incidence dipped marginally by 1%.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The number of notified cases of <\/span><b>drug-resistant tuberculosis (MDR-TB) <\/b><span style=\"font-weight: 400;\">jumped from 79,000 to 84,000 in 2016.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The <\/span><b>use of molecular diagnostic tests <\/b><span style=\"font-weight: 400;\">has scaled up to detect the infection even on detection of drug-resistant TB, which is <\/span><b>an improvement<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">India with 1.7 million new cases in 2016 continues to be the <\/span><b>largest contributor to the global burden<\/b><span style=\"font-weight: 400;\"> with up to a quarter of the 6.3 million new cases of TB.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">India accounts for about <\/span><b>32% of the number of people<\/b><span style=\"font-weight: 400;\"> worldwide who succumbed to the disease.<\/span><\/li>\n<\/ul>\n<p><b>Government initiative<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The government has <\/span><b>committed to achieve a \u201890-90-90 target\u2019 by 2035<\/b><span style=\"font-weight: 400;\"> i.e., 90% reductions in incidence, mortality and catastrophic health expenditures due to TB.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The target is premised on <\/span><b>improved diagnostics<\/b><span style=\"font-weight: 400;\">, <\/span><b>shorter treatment courses<\/b><span style=\"font-weight: 400;\">, <\/span><b>a better vaccine<\/b><span style=\"font-weight: 400;\"> and <\/span><b>comprehensive preventive strategies<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">However, several activists say that in spite of the government commitments, <\/span><b>TB is still stigmatized<\/b><span style=\"font-weight: 400;\"> and <\/span><b>under-reported<\/b><span style=\"font-weight: 400;\"> especially from the private sector and <\/span><b>top-line drugs are still inadequate<\/b><span style=\"font-weight: 400;\"> to treat people who suffer from the drug-resistant forms of the disease.<\/span><\/li>\n<\/ul>\n<p><b>Directly Observed Treatment Short Course (DOTS)<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">For the past two decades, India has slowly come to grips with regular strains of TB under a World Health Organization program known as DOTS or Directly Observed Treatment Short Course, in which <\/span><span style=\"font-weight: 400;\">patients are given free drugs but have to take them three times a week<\/span><span style=\"font-weight: 400;\">, in the presence of a health worker or volunteer, for at least two months.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">It involved a monumental effort perhaps bettered only by the country\u2019s successful program to eradicate polio but India now meets global targets by <\/span><b>detecting more than 70 percent of TB cases<\/b><span style=\"font-weight: 400;\"> and <\/span><b>curing more than 85 percent of those detected.<\/b><\/li>\n<\/ul>\n<p><b>Multi-drug-resistant<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Although drug-resistant TB can be transmitted from patient to patient, regular strains of TB still dominate.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Just <\/span><b>2 percent<\/b><span style=\"font-weight: 400;\"> of new TB cases in India are found to be <\/span><b>multi-drug-resistant<\/b><span style=\"font-weight: 400;\">; the majority of cases are in patients where the disease has recurred after unsatisfactory treatment.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The problem of drug resistance is manageable, but it is growing and if controls are not introduced over use of antimicrobials [drugs] and people are not put into right treatment regimens, <\/span><b>it will grow.<\/b><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Almost half of the six lakh rifampicin resistant multi-drug resistant tuberculosis cases in the world were in India, China, and Russian Federation.<\/span><\/li>\n<\/ul>\n<p><b>What is Tuberculosis?<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Tuberculosis (TB) is a<\/span><b> multi-systemic infectious disease<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">It is <\/span><b>caused by a bacteria<\/b><span style=\"font-weight: 400;\"> called as <\/span><b>Mycobacterium tuberculosis.<\/b><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">It is a <\/span><b>communicable disease<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<\/ul>\n<p><b>What are the causes of tuberculosis?<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Microscopic droplets:<\/b><span style=\"font-weight: 400;\"> Tuberculosis is caused by bacteria that spread from person to person through microscopic droplets released into the air.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>HIV and TB<\/b><span style=\"font-weight: 400;\">: Infection with HIV suppresses the immune system, making it difficult for the body to control TB bacteria.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">As a result, people with HIV are many times more likely to get TB and to progress from latent to active disease than are people who aren\u2019t HIV positive.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Drug-resistant TB:<\/b><span style=\"font-weight: 400;\"> Another reason of tuberculosis is the increase in drug-resistant strains of the bacterium.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Drug-resistant strains of tuberculosis emerge when an antibiotic fails to kill all of the bacteria it targets.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The surviving bacteria become resistant to that particular drug and frequently other antibiotics as well.<\/span><\/li>\n<\/ul>\n<p><b>What are the different types of Tuberculosis?<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">There are many types of tuberculosis, but the main two types are termed as:<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Active tuberculosis infection: <\/b><span style=\"font-weight: 400;\">when the disease is actively producing symptoms, and can be transmitted to other people.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Latent tuberculosis infection:<\/b><span style=\"font-weight: 400;\"> when the person is infected with Mycobacterium tuberculosis bacteria, but the bacteria is not producing symptoms.<\/span><\/li>\n<\/ul>\n<p><b>Other forms of Tuberculosis are:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Pulmonary tuberculosis<\/b><span style=\"font-weight: 400;\"> mainly infects the pulmonary system;<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Cutaneous tuberculosis<\/b><span style=\"font-weight: 400;\"> has skin symptoms;<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Military tuberculosis<\/b><span style=\"font-weight: 400;\"> describes widespread small infected sites.<\/span><\/li>\n<\/ul>\n<p><b>WHO\u2019s treatment guidelines for drug-resistant tuberculosis:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The WHO treatment guidelines for drug-resistant tuberculosis (2016 update) contain policy recommendations on priority areas in the treatment of drug-resistant tuberculosis.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The revision is in accordance with the WHO requirements for the formulation of evidence-informed policy.<\/span><\/li>\n<\/ul>\n<p><b>The main highlights of the WHO guidelines, 2016-17 are:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">A shorter MDR-TB treatment regimen is recommended under specific conditions;<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Medicines used in the design of conventional MDR-TB treatment regimens are now reclassified to reflect updates in the evidence on their effectiveness and safety;<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Specific recommendations are made on the treatment of children with rifampicin-resistant or MDR-TB based on a first-ever individual patient data meta-analysis;<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Recommendations on the role of surgery in MDR-TB case management are included.<\/span><\/li>\n<\/ul>\n<p><b>What is the Revised National Tuberculosis Control Program (RNTCP)?<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><b>Revised National Tuberculosis Control Program (RNTCP)<\/b><span style=\"font-weight: 400;\"> is the state-run tuberculosis (TB) control initiative of the Government of India.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">As per the National Strategic Plan 2012\u201317, the program has a vision of achieving a \u201cTB free India\u201d.<\/span><\/li>\n<\/ul>\n<p><b>Objectives:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">RNTCP <\/span><b>provides various free of cost, quality tuberculosis diagnosis and treatment services<\/b><span style=\"font-weight: 400;\"> across the country through the government health system.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The program uses the World Health Organisation (WHO) recommended <\/span><b>Directly Observed Treatment Short Course (DOTS) strategy<\/b><span style=\"font-weight: 400;\"> and reaches over a billion people in 632 districts\/reporting units.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">It is also <\/span><b>responsible for carrying out the Government of India five year TB National Strategic Plans<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<\/ul>\n<p><b>Loopholes in the program:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Though the Revised National Tuberculosis Control Programme (RNTCP) has treated 10 million patients, the rate of decline has been slow.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">RNTCP failed on universal access to early diagnosis and treatment and improving case detection.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Also, India is far from reaching the 2030 Sustainable Development Goals, i.e. reducing the number of deaths by 90% and TB incidence by 80% compared with 2015. \u00a0<\/span><\/li>\n<\/ul>\n<p><b>What is National Strategic Plan for tuberculosis 2017\u2013 2025?<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The national strategic plan for tuberculosis elimination (2017-2025), has set a goal of \u201c<\/span><b>achieving a rapid decline in burden of TB, morbidity and mortality while working towards elimination of TB by 2025<\/b><span style=\"font-weight: 400;\">.\u201d<\/span><\/li>\n<\/ul>\n<p><b>Highlights:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The TB control programme plans to <\/span><b>do away with the strategy of waiting for patients to walk in to get tested<\/b><span style=\"font-weight: 400;\"> and instead engage in detecting more cases, both drug-sensitive and drug-resistant.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The emphasis will be on <\/span><b>using highly sensitive diagnostic tests, undertaking universal testing for drug-resistant TB, reaching out to TB patients seeking care from private doctors and targeting people belonging to high-risk populations<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The other priority is to <\/span><b>provide anti-TB treatment irrespective of where patients seek care from, public or private and ensure that they complete the treatment<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">The TB control programme also talks of having in place <\/span><b>patient-friendly systems to provide treatment and social support<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Threefold rise in domestic budget for fight against tuberculosis: Context According to a report from the World Health Organisation (WHO), India\u2019s domestic budget for fighting tuberculosis showed a dramatic jump from about \u20b9700 crores in 2015 to \u20b92,500 crores last year. Why is it important? Most of India\u2019s budget to combat the bacterial infection use&hellip; <a class=\"more-link\" href=\"https:\/\/forumias.com\/blog\/threefold-rise-in-domestic-budget-for-fight-against-tuberculosis\/\">Continue reading <span class=\"screen-reader-text\">Threefold rise in domestic budget for fight against tuberculosis:<\/span><\/a><\/p>\n","protected":false},"author":61,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"footnotes":""},"categories":[555],"tags":[],"class_list":["post-34254","post","type-post","status-publish","format-standard","hentry","category-test-1","entry"],"jetpack_featured_media_url":"","views":{"total":0,"cached_at":"","cached_date":1704582560},"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/34254","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/users\/61"}],"replies":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/comments?post=34254"}],"version-history":[{"count":0,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/34254\/revisions"}],"wp:attachment":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media?parent=34254"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/categories?post=34254"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/tags?post=34254"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}