Introduction TB Elimination

Overview Tuberculosis (TB)

is an infectious disease caused by a bacterium, Mycobacterium tuberculosis and usually spreads through respiratory droplets/droplet nuclei in the air. When these droplets are inhaled by a healthy person, she/he gets infected with tuberculosis. This infected person has a 10-15% lifetime risk of developing TB and a single patient (if not on treatment) can infect 10 or more people in a year. The National TB Elimination Programme (NTEP) is a Centrally Sponsored Scheme, being implemented under the umbrella of National Health Mission (NHM) with vision of TB Free India, wherein free diagnostic and quality assured treatment are provided to all TB patients, along with Nutritional support. India has made great strides in TB elimination efforts over the years. Since 2015, the annual TB incidence rate has declined by 18% and the mortality rate has declined 22% as of 2023. TB incidence rate has decreased from 237 cases per lakh population (in 2015) to 195 (in 2023). Similarly, TB death rate has decreased from 28 deaths per lakh population (in 2015) to 22 (in 2023).

Rationale of the campaign of TB Elimination

In view of the progress made so far and to address the challenges in achieving SDG goals, there is a felt need for a renewed approach. The TB burden in India has wide variations in incidence ranging from 12 to 595 cases per lakh population across different geographies in the country. Also, the progress made on key performance indicators (KPIs) by the State/UTs also have wide variations. Hence, to accelerate efforts in finding missing cases, reducing TB deaths and prevention of new cases; a geography specific approach has been designed to be implemented through this campaign. While routine programmatic activities will continue in all districts/blocks, the campaign will focus on vulnerable population in selected priority districts for increased case detection, increased coverage of nutrition interventions and increased awareness in the community towards importance of early detection and complete treatment of TB.

Goal of the campaign

1. To increase case detection through intensified IEC campaign on community awareness and screening & testing of vulnerable populations including asymptomatic individuals. 2. To reduce death among people with TB by implementing a differentiated TB care approach with nutritional support interventions 3. To prevent occurrence of new TB cases in the community by providing TB preventive treatment to household contacts, PLHIV & vulnerable populations 347 districts have been selected across 33 State/UTs. These districts include 38 tribal districts, 27 mining districts, and 46 aspirational districts among others.

Campaign Activities

Screening of Vulnerable Population such as household contacts, individuals with history of TB, diabetics, PLHIV, smokers, alcoholics, elderly (>60 years), and undernourished individuals (BMI <18.5) and Congregate Settings and Workplaces Testing through X-ray for all Vulnerable population including asymptomatic individuals and NAAT for upfront diagnosis of TB. Promptly initiation of treatment for diagnosed patients with differentiated care for high-risk individuals. Ensure Ni-kshay Poshan Yojana benefits to all TB patients and nutrition kits for family members through Ni-kshay mitras. After ruling out TB provide TB preventive treatment for eligible high-risk individuals.

Janbhagidari for TB Mukt Bharat

Janbhgidari (community participation) for TB Mukt Bharat is an important element of the ‘100 days campaign’ to foster community participation and whole of government approach for TB elimination. The objective of Janbhagidari is to raise awareness TB symptoms, reduce stigma around TB, encourage early detection of TB, support treatment, nutrition and promote TB prevention Janbhagidhari activities will involve stakeholders, like elected representatives, panchayati raj institutions, urban local bodies, community structures (VHSNC, SHGs, JAS, MAS), TB vijeyeta (TB champions), local NGOs & development partners, community influencers, religious leaders, schools, colleges, government dept (other than health), workplaces, industries, media persons / journalists etc. “India has worked together on many fronts in this fight against TB in the last nine years. For example, People’s Participation — Jan Bhagidari; Enhancing Nutrition — a special campaign for nutrition; Treatment Innovation – a new strategy for treatment; Tech Integration – maximum use of technology; and Wellness and Prevention – campaigns to promote good health such as Fit India, Khelo India, Yoga etc”