Latest news with #NationalTuberculosisEliminationProgramme
Indian Express
a day ago
- Health
- Indian Express
Closing In On TB
Prime Minister Narendra Modi recently reviewed the National Tuberculosis Elimination Programme (NTEP). His emphasis on public participation and scaling up successful and innovative strategies comes at a critical time. Advances in diagnostics, digital tools, and vaccines are creating opportunities to reshape how we detect, treat, and prevent TB. Progress in recent years is encouraging. According to the WHO's 'Global TB Report 2024', global TB incidence fell by 8.3 per cent between 2015 and 2023. India outpaced this trend, achieving a 17.7 per cent reduction. These gains reflect the focused efforts and commitment of the NTEP. As we look to sustain and accelerate these gains, we must focus on closing the diagnostic gap — the most critical weak link in the TB care cascade. In 2023, an estimated 2.7 million people worldwide who developed TB were not diagnosed or notified. Without diagnosis, timely treatment is impossible, and the chain of transmission continues. Compounding this challenge is the emerging evidence that a significant number of TB patients do not exhibit symptoms. Studies suggest that this early stage of the disease, known as subclinical TB, may account for about 50 per cent of cases in high-burden settings, including India. This is likely a key driver of the ongoing transmission. India's recently concluded 100-day intensified TB-Mukt Bharat Abhiyaan has provided several learnings. By screening vulnerable populations, including those without symptoms, the programme noted that the campaign identified 2.85 lakh asymptomatic TB patients — out of 7.19 lakh diagnosed. These individuals would likely have been missed under conventional, symptom-based screening approaches. By deploying portable chest X-rays, the campaign demonstrated the transformative potential of technology. AI-assisted reading of X-rays can detect lung abnormalities rapidly and accurately, allowing for quick identification of otherwise 'missing' cases. The government's plan to scale up this approach country-wide is encouraging and could serve as a global model. A new generation of point-of-care diagnostic tools is transforming what's possible. Traditional sputum-based tests can be challenging, particularly for children and the elderly. But innovations — such as non-invasive sampling methods like tongue or nasal swabs — can help detect TB earlier and more affordably. The availability of open PCR platforms can be another game-changer — by cutting the cost of testing significantly, these platforms can make high-quality molecular diagnostics accessible across public and private settings. In India, several of these tools are already being piloted, and the Indian Council of Medical Research is playing a key role in facilitating their adoption into routine care. Along with the upgradation of our diagnostic capacity, we must look at reducing mortality due to TB. India has taken important steps to improve supportive care, including the doubling of monthly nutritional support under the Nikshay Poshan Yojana (NPY) — a direct cash transfer scheme that helps patients meet their dietary needs during treatment. This expansion is timely, as undernutrition remains one of the leading risk factors for TB progression. The country is also moving toward differentiated models of TB care, where services are tailored based on a patient's risk profile and severity at diagnosis. This includes early risk stratification, timely referral of severe cases to higher-level facilities, and the provision of more intensive inpatient care where needed. This approach can drive down mortality appreciably and must become a core feature of the TB response. We must prioritise reducing TB deaths to as close to zero as possible in the near future. While these advancements in diagnostics, treatment, and care delivery are crucial, we must not lose sight of the long-term solution — an effective TB vaccine. The experience of developing Covid vaccines demonstrates how global collaboration, streamlined regulatory pathways, and strong public investment can significantly accelerate timelines — an approach that must now be applied to TB vaccine development. India, with its scientific leadership and manufacturing capacity, is uniquely placed to drive the development and equitable deployment of next-generation TB vaccines, just as it did with Covid. An mRNA vaccine is in an early stage of development in India, and others are at various stages of clinical trials. PM Modi's leadership has played a pivotal role in keeping TB elimination high on the national agenda and inspiring other countries to set ambitious goals. With continued political commitment, evidence, data-informed policies and a strong focus on innovation, India can drive transformative change in the global fight against TB. The writer is chairperson, MS Swaminathan Research Foundation and principal advisor, NTEP, Ministry of Health and Family Welfare
Time of India
25-06-2025
- Health
- Time of India
Wounds beyond treatment! Women with TB face social rejection
Lucknow: From exclusion from marriage and divorce to rejection by families, a significant number of women diagnosed with tuberculosis (TB) are facing social challenges. This was revealed in a new study by KGMU. Published in The Journal of Association of Chest Physicians this month, the study found that 10 per cent of marriages involving female TB patients ended in divorce- especially among younger women- while 40 per cent of unmarried women reported being denied marriage after diagnosis. Additionally, 25 per cent of women felt alone in their own homes and 18 per cent were rejected by husbands or in-laws, with an alarming 10 per cent ending into divorces. The study analysed 960 new female TB cases registered under the National Tuberculosis Elimination Programme (NTEP) at KGMU's DOTS centre. It revealed that the disease's impact goes well beyond medical symptoms, exposing a deep-rooted social stigma. "Our study demonstrates that TB is not merely a medical challenge; it's a deep-seated societal issue, especially for women. While the medical community focuses on treatment, we cannot ignore the psychological, social, and economic hardships that devastate women's lives," said Dr Jyoti Bajpai, lead researcher from the respiratory medicine at KGMU. The research found that although nearly 70 per cent of participants (around 664 women) were aware of the seriousness of TB and the need for completing treatment, 50 per cent were afraid to reveal their illness due to fear of stigma. As a result, 44 per cent reduced their social activities and became isolated. Older women (aged 45 and above) faced challenges too - 16 per cent (154 widows) reported serious social difficulties following diagnosis. Surprisingly, stigma was more pronounced among women from middle and upper-middle-class families compared to those from lower-income backgrounds. A key observation in the study was the contrast in family support provided to male and female patients. Dr Kanchan Srivastava, co-author of the study said: "We observed a critical gender gap. While male TB patients typically received care and support from their wives, female patients often did not experience the same level of reciprocal support, highlighting a significant disparity in family dynamics and societal expectations." Dr Shubhajeet Roy, another researcher, stressed the urgency of tackling these issues. "These findings are crucial because they underscore that merely treating the disease isn't enough. We need a holistic approach that tackles the root causes of discrimination and provides robust social safety nets for women." To reduce stigma and improve treatment outcomes, the researchers advocate for stronger awareness and community support. "To truly end the epidemic and dismantle its associated stigma, our community education initiatives must actively debunk falsehoods about the disease. We need to encourage early detection and, crucially, stress the invaluable importance of completing the full course of treatment," said Dr Jyoti. The study recommends setting up therapy services and support groups tailored for women with TB. "Establishing women's therapy services and support groups can be transformative. These platforms can help patients cope with psychological suffering, foster peer support, and empower them to overcome social obstacles," said Dr Apoorva Narain, another researcher. Furthermore, socioeconomic empowerment programmes offering financial assistance and skill development are vital to help women regain their independence, ensure treatment adherence, and reintegrate into their communities with dignity, said researchers.
Time of India
24-06-2025
- Health
- Time of India
Wounds beyond treatment! Women with TB face social rejection
Lucknow: From exclusion from marriage and divorce to rejection by families, a significant number of women diagnosed with tuberculosis (TB) are facing social challenges. This was revealed in a new study by KGMU. Published in The Journal of Association of Chest Physicians this month, the study found that 10% of marriages involving female TB patients ended in divorce— especially among younger women— while 40% of unmarried women reported being denied marriage after diagnosis. Additionally, 25% of women felt alone in their own homes and 18% were rejected by husbands or in-laws, with an alarming 10% ending into divorces. The study analysed 960 new female TB cases registered under the National Tuberculosis Elimination Programme (NTEP) at KGMU's DOTS centre. You Can Also Check: Lucknow AQI | Weather in Lucknow | Bank Holidays in Lucknow | Public Holidays in Lucknow It revealed that the disease's impact goes well beyond medical symptoms, exposing a deep-rooted social stigma. "Our study demonstrates that TB is not merely a medical challenge; it's a deep-seated societal issue, especially for women. While the medical community focuses on treatment, we cannot ignore the psychological, social, and economic hardships that devastate women's lives," said Dr Jyoti Bajpai, lead researcher from the respiratory medicine at KGMU. T he research found that although nearly 70% of participants (around 664 women) were aware of the seriousness of TB and the need for completing treatment, 50% were afraid to reveal their illness due to fear of stigma. As a result, 44% reduced their social activities and became isolated. Older women (aged 45 and above) faced challenges too — 16% (154 widows) reported serious social difficulties following diagnosis. Surprisingly, stigma was more pronounced among women from middle and upper-middle-class families compared to those from lower-income backgrounds. A key observation in the study was the contrast in family support provided to male and female patients. Dr Kanchan Srivastava, co-author of the study said: "We observed a critical gender gap. While male TB patients typically received care and support from their wives, female patients often did not experience the same level of reciprocal support, highlighting a significant disparity in family dynamics and societal expectations." Dr Shubhajeet Roy, another researcher, stressed the urgency of tackling these issues. "These findings are crucial because they underscore that merely treating the disease isn't enough. We need a holistic approach that tackles the root causes of discrimination and provides robust social safety nets for women." To reduce stigma and improve treatment outcomes, the researchers advocate for stronger awareness and community support. "To truly end the epidemic and dismantle its associated stigma, our community education initiatives must actively debunk falsehoods about the disease. We need to encourage early detection and, crucially, stress the invaluable importance of completing the full course of treatment," said Dr Jyoti. The study recommends setting up therapy services and support groups tailored for women with TB. "Establishing women's therapy services and support groups can be transformative. These platforms can help patients cope with psychological suffering, foster peer support, and empower them to overcome social obstacles," said Dr Apoorva Narain, another researcher. Furthermore, socioeconomic empowerment programmes offering financial assistance and skill development are vital to help women regain their independence, ensure treatment adherence, and reintegrate into their communities with dignity, said researchers.
Hindustan Times
24-06-2025
- Health
- Hindustan Times
Harnessing India's medical colleges in the fight against TB
India has made undeniable progress in its battle against tuberculosis (TB). The World Health Organization (WHO) acknowledged a 17.7% drop in TB incidence in the country from 237 to 195 per lakh population between 2015 and 2023 – double the pace observed globally. Despite these advancements, India continues to bear the highest TB burden globally1, making the goal of a TB-free India even more urgent. Against this backdrop, medical colleges have emerged as vital players in the national TB response - providing a template for other disease programmes to tap into their potential for a healthier India. TB (AFP) Harnessing India's vast network of medical colleges is a cornerstone of the nation's ambitious strategy to eliminate TB by 2025. These institutions have transitioned from peripheral actors to central pillars in the fight against TB, contributing significantly to nearly every facet of the National Tuberculosis Elimination Programme (NTEP). Medical colleges have evolved beyond tertiary referral centres to become critical nodes in India's public health infrastructure and the TB elimination response. They serve patients from both within and beyond their districts and states, offering significant potential for case detection not just in TB and respiratory departments, but across all specialties. Equipped with advanced laboratories and specialised centres, nearly all of India's 651 medical colleges are working closely with the NTEP. Notably, 336 medical colleges have centres dedicated to managing drug-resistant TB, a more complex and harder-to-treat form of the disease. With cutting-edge diagnostic tools and clinical expertise in handling health complications, these institutions are leading to better TB care and outcomes. In 2023, medical colleges notified nearly 14% of all TB cases in India – a clear sign of their growing role in this national effort. Medical colleges are playing an increasingly important role in responding to the emerging trends in the TB epidemic. Extra-pulmonary forms of the disease that occur outside the lungs are on the rise and are generally harder to detect and treat. It now makes up 20-24% of all TB cases in India, especially among people with weaker immunity. With their advanced labs, specialist departments, and tertiary care capacity, medical colleges are uniquely positioned to deliver the multi-disciplinary care required to detect and manage these harder-to-treat cases. Medical colleges are also well placed to design and implement innovative health solutions, with research and practice occurring side by side. For example, the Bharati Vidyapeeth Medical College in Pune repurposed its Family Adoption Programme – where each student engages with five families over three years – to integrate community-based TB screening into the existing medical curriculum. This not only helped detect cases in the community, but also taught students to recognise key TB symptoms, demonstrating a scalable model for active case finding. One of our standout achievements has been fostering global collaborations. The ongoing partnership between AIIMS Gorakhpur and Johns Hopkins University through the TB-Free Schools initiative aimed at early detection, treatment, and prevention of TB among students in residential schools, demonstrates how Indian medical colleges can drive impactful international engagement. As this model is scaled, it reinforces what we have long championed—that medical colleges, when systematically integrated with state health systems, are among the most cost-effective and scalable platforms for delivering high-impact TB interventions. By leveraging these institutions, we can enhance passive case finding, improve diagnosis, and ensure timely treatment. With a structured mechanism for accountability under NTEP, medical colleges can become hubs for TB management. Furthermore, they are instrumental in building a competent healthcare workforce by integrating practical, programme-oriented TB management skills into the medical curriculum, thereby preparing a new generation of doctors for the challenges of TB elimination. Through a structured framework of national, zonal, and state-level task forces, medical colleges contribute to operational research, generating vital evidence to refine public health strategies and improve patient outcomes. By embedding themselves within the community through initiatives like the Family Adoption Programme, they also bolster active case finding efforts, ensuring early diagnosis and treatment, thus playing an indispensable and multifaceted role in India's journey towards a TB-free future. For TB and other critical public health challenges, where understanding patient behavior, treatment barriers, and local epidemiology is critical, the ability of medical colleges to connect science with ground-level implementation is key to turning policy into real-world action. They have technical expertise to strengthen surveillance systems, research capacity to strengthen monitoring and evaluation, and educational mandate to build local capability through supportive supervision. The integration of medical colleges into the TB elimination framework has been one of the most strategic shifts under the NTEP. Medical colleges have redefined their role in public health, not only by contributing to TB management, but by setting a precedent for how academic institutions can anchor systemic change. Their success is not incidental; it is the result of sustained collaboration, institutional commitment, and a shared vision of making India TB-free. Importantly, the integration of medical colleges into the TB response offers a replicable framework for tackling other complex health challenges in India – such as anti-microbial resistance, non-communicable diseases, and neglected tropical diseases – through a blend of research, education, service delivery, and community engagement. This article is authored by Dr Ashok Bhardwaj, professor emeritus, MM Medical & Hospital College Solan, Himachal Pradesh and chairperson of the National Task Force for Medical Colleges under NTEP and Dr Bhupendra Tripathi, deputy director, Infectious Diseases and Vaccine Delivery, Gates Foundation, India.
Scroll.in
13-06-2025
- Health
- Scroll.in
As counsellors, they help fellow TB patients recover. Now a fund squeeze has left them high and dry
In January 2020, an official at a primary health centre in Jharkhand told Khageshwar Kumar about a drug-resistant tuberculosis patient who had stopped taking medicines for the last two months. Kumar stepped in. For 18 months, he visited the patient in Parasnath block in Giridih district three times a week, counselling him in sessions that lasted three hours or more. 'He had become suicidal. Even his family had given up on his treatment,' Kumar said. 'For hours I would talk to him. I was able to help him because I was a TB patient myself. I can relate to how patients feel.' Kumar is a TB Champion or TB Vijeta, a term coined for patients cured of the bacterial infection, who are then drafted to the National Tuberculosis Elimination Programme. Their role – to counsel other patients and raise community awareness. In this case, Kumar's efforts paid off. He convinced the patient to resume his medicines and helped him through their painful side-effects. The patient went on to finish his treatment in 2022 and is now employed with a private firm. Khageshwar Kumar was diagnosed with tuberculosis in 2007 and cured the same year. The 29-year-old began working as a TB Champion in Giridih in 2019 for an honorarium of Rs 6,000 per month. 'The amount was small, but I had no other job and I was passionate about TB,' he said. Since 2023, however, that money has stopped. Several TB Champions have dropped out of the programme in Jharkhand, though some like Kumar do limited volunteer service in spare time. 'For how long can we work for free?' Kumar asked. A support group The TB Champion programme was initiated in India in 2016 as a major component under the National Tuberculosis Elimination Programme, which aimed to eradicate tuberculosis by 2025. The deadline, missed by India, has now been pushed to 2030. But across India, the programme is under stress, with multiple states complaining of delay in financial reimbursement or a complete freeze in funds. Each state allocates a different amount as fee for the former tuberculosis patients. In some states, NGOs partner with the government and pay the amount. In May, Nishant Kumar, joint director of the central tuberculosis division was asked why the programme was struggling at a conference. 'TB Champions (programme) has not stopped,' Kumar said. 'It is transitioning.' But several counsellors Scroll spoke to said irregular payments are a problem. In Haryana, Sagar Verma, who is the TB Champions Network President, said he received Rs 8,000 per month until 2024 through an NGO called World Vision that had partnered with the government. 'It stopped due to funds shortage,' he said. Verma now works at a district hospital in Haryana. 'There are over 100 counsellors like me who are jobless in the state. We have approached state authorities multiple times to release funds for this programme,' Verma said. The last time, the counsellors engaged with tuberculosis patients in Haryana was March 2024. In Odisha, counsellor Kailash Mishra has not received April's honorarium till date. 'The state government said that March funds have not reached them from the Centre.' Mishra visits four patients every day and does regular district level reporting of cases apart from conducting community meetings to raise awareness. For this, he receives Rs 3,500 a month from the Odisha government. 'The payment is frequently delayed,' he said. 'Many of us travel 200 km to district headquarters for meetings. Sometimes we also collect sputum to test for TB bacteria,' Mishra said. Although the National Tuberculosis Elimination Programme permits states to reimburse counsellors for such services, Mishra said no reimbursement is given to them. Eldred Tellis, founder of Sankalp Rehabilitation Trust, said the issue has become acute in the last few months. 'Whenever we approach state officials, they cite fund shortage,' he said. 'The central ministry refuses to acknowledge this problem. This has not only cut the source of livelihood for TB Champions, it has also affected patient care.' Other health activists agreed that the absence of the counsellors would hurt patients. 'TB Champions fill a crucial gap in the programme by providing mental health support to patients,' said health activist Ganesh Acharya. 'In their absence a major component will be lost.' 'A vital part' In 2016, Reach, a non-profit that partnered with the government on tuberculosis control, trained its first cohort of 25 TB Champions and went on to train 3,000 such counsellors. Ramya Ananthkrishnan, director at Reach, said the aim was to provide a support group for TB patients. 'They play a vital part. Some look at advocacy, some get deeply involved in the programme to handle treatment and diagnosis,' she said. Across India, the National Tuberculosis Elimination Programme has trained over 30,000 champions till 2023. In Mumbai, a hotbed of drug-resistant tuberculosis, the Brihanmumbai Municipal Corporation relied heavily on the TB Champions to carry out door-to-door visits and engage with the community. Till last year, Maharashtra paid the highest compensation to the counsellors, at Rs 10,000 a month. Moreover, the counsellors were employed by the civic body on a contractual basis. But in June 2024, the civic body discontinued the programme. About 25 people employed to counsel patients were rendered jobless. 'Few were retained and assured of payment. But since the last eight months, they have not been paid,' said activist Meera Yadav. Yadav said that the funds meant for the programme were discontinued by the state's TB division due to overall budget cuts. A state government official requesting anonymity said funds under the National Health Mission have been "delayed consistently'. 'We use NHM funds for various diseases, including tuberculosis,' the official said. 'This year, the funds were supposed to be disbursed by March. We have not received them till now.' The delay and underutilisation of funds is apparent in the 2023-24 budget and expenditures made by the National Tuberculosis Elimination Programme. Out of a budget of Rs 1,888 crore, the programme had spent only Rs 840 crore till March 15, 2024. For 2022-23, the programme spent Rs 910 crore out of the approved budget of Rs 1,666 crore. Some officials employed with NGOs, who work with the government on tuberculosis, told Scroll that the abrupt end of funds from the United States Agency for International Development this January has also forced them to curtail spending on TB Champions. Shazad Ahmed, who is a TB Champion in Balrampur, Uttar Pradesh, stopped receiving a monthly honorarium of Rs 8,000 from 2024. He was being paid by Reach. He still continues to work though in the hope the government will resume payments. 'I am working to help other patients. I will continue to work for free as long as possible.'
