Need to address drug-resistant TB cases in India: Health Secy

New Delhi: India accounts for nearly one-fourth of global incidence of tuberculosis and public health officials here are working on finding a cure for drug-resistant tuberculosis, Union Health Secretary Luv Verma today said.

"India has the highest tuberculosis burden in the world, accounting for nearly one-fourth of the global incidence. In 2012, out of the estimated global annual incidence of 8.7 million TB cases, 2 to 2.4 million were estimated to have occurred in India," he said.

Verma was addressing the ASSOCHAM Tuberculosis Awareness, Prevention and Wellness Programme here.

Under the national tuberculosis control programme (RNTCP), treatment success rates have tripled from 25 per cent in pre-RNTCP era to 88 per cent upto 2012 and TB death rate has reduced from 29 per cent to 4 per cent during the same period.

Inception of the programme has examined more than 144 million TB suspects, also diagnosed more than 18 million TB cases and saved more than 3.2 million lives.

"To improve access to tribal and other marginalized groups the programme has developed a Tribal action plan which is being implemented with the provision of additional TB units and DMCs in tribal and difficult areas along with additional staff, compensation for transportation of patient and attendant and higher rate of salary to contractual staff," the Union Health Secretary said.

Nearly 3,397 NGOs collaborations and 13,525 private practitioners are involved in the programme in different signed schemes.

Dr Nata Menabde, WHO Representative to India, stressed on urgent need to improve efforts to prevent and address the social determinants of health.

"India has 26 per cent of the incident TB cases globally. Annually, 1.3 million incident TB cases are notified to the national programme. The patients who access the public health programme get quality assured diagnosis and treatment.

"However, there are an estimated 2.2 million incident TB cases in India. Hence, there are nearly a million cases missing from notification. This missing million, are unable to avail government services as most of them are managed in the private sector," Nata said.

The WHO representative noted that any efforts in TB control are unlikely to yield the desired results, unless they are accompanied by efforts to reduce TB transmission through improved living conditions, housing, nutrition, and reduction of airborne transmission for a large part of the population.

Nata said controlling both drug sensitive TB and Drug Resistant TB cannot be done through the public sector alone and efforts need to be made to stop new infections and prevent an entire generation of new drug-resistance cases.

"We have to think innovatively, change our approach and commit ourselves to working with both the formal and non-formal private sector to address this issue. I must reiterate here that our current efforts to prevent the emergence of drug resistance are grossly inadequate," she added.

India has already made a number of bold policy decisions to control TB which include banning of commercial serology for TB diagnosis following a WHO recommendation, mandatory notification of all TB patients, and including anti-TB drugs under a special drug regulation schedule called H1, thereby restricting their sale only through valid prescriptions.

Nata said stronger laws are needed to ensure accountability of all health care providers for patient's adherence to anti-TB drugs, which is particularly crucial for prevention of drug resistance.

D S Rawat, secretary general, ASSOCHAM, said that it is critical to bring together various stakeholders who can address the problem on one platform to identify how they can collaborate, and share best practices and successes.