5 Questions: Rakesh Sinha on progress of TB elimination programme

Nominated MP Rakesh Sinha on Tuesday raised a question on the progress of the country’s TB elimination programme. He spoke to Anonna Dutt.

What made you raise the question?

India has one-fourth of the world’s TB cases. And we realised the gravity of the situation in 2017 when the Prime Minister set the target of eliminating TB by 2025. That became a benchmark and the entire machinery started working on tuberculosis. That’s when a holistic approach for TB elimination started and there is a need to focus on extra-pulmonary TB (TB outside the lungs) as well.

What are the issues surrounding extra-pulmonary TB?

I consulted many people and found that in rural areas when someone has extra-pulmonary TB… like in the stomach, brain, or bone… and they go to the doctor… if their lungs are clear they are not diagnosed with TB. Therefore diagnosis happens at the fag end of the disease. Then I consulted doctors and found out the entire focus of the programme is on the lungs.

What needs to be done?

It is a question of medical governance. With the cases of extra-pulmonary TB rising (it increased from 26% of all reported TB cases in 2019 to 29% till May 31 2022, as per data tabled in Parliament), such people (experts on non-pulmonary TB) need to be included in policy making, programme implementation and in peripheral health centres. Even at the level of diagnosis, we have to change the approach.

What has changed since 2017?

Before the programme started, we did not know the exact number of TB patients in the country. After 2017, it became mandatory to report all TB cases. A link has been established between patients, doctors, and hospitals. The private sector has been brought into the folds. And diagnostics are reaching the periphery.

Can we eliminate TB by 2025?

The Covid-19 pandemic in the last two years disturbed the programme, but we still have three years to go. With dedicated work, nothing is impossible. There is a need to identify the patients, treat them, and localise them or limit their travel and interaction. The peripheral healthcare system needs to be strengthened, doctors who can treat extra-pulmonary TB need to be increased, and pharmacies need to report people who come to get the medicine so cases are not missed. Timely, proper treatment can stop drug-resistance.

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