Decline in TB cases & deaths in India ‘remarkable’, shows ‘political commitment’, says former WHO Director

New Delhi (The Uttam Hindu): The significant drop in tuberculosis (TB) cases and deaths in India is "remarkable", said Mario C. B. Raviglione, former Director of the Global Tuberculosis (TB) Programme at the World Health Organization (WHO) on Sunday. Speaking exclusively to IANS, Raviglione noted that this indicates a "high level of political commitment."“There has been major progress in India in the last 25 years. The 18 per cent decline is about 2 per cent per year in the last decade. It is something remarkable for a country like India which is the number one contributor to the global TB epidemic with an estimated 2.8 million people getting TB every year,” said Raviglione, a Professor of Global Health at the University of Milan, Italy.

As per recent government data, the incidence rate of TB witnessed a 17.7 per cent decline from 237 per 100,000 population in 2015 to 195 per 100,000 population in 2023. Similarly, deaths due to TB have reduced by 21.4 per cent from 28 per lakh population in 2015 to 22 per lakh population in 2023. “Having achieved this incidence decline in a country as massive as India is certainly a sign that something good has been done,” said Raviglione. “I think that the high level of political commitment that has been seen in India over the past few years is absolutely remarkable. It is almost unique in the world. I've not seen many heads of state going loudly like Prime Minister Narendra Modi” on tackling diseases, he added, noting that it must be “absolutely maintained” to help the country fight the deadly infectious disease. While the “decline is still remarkable, it is far too slow to achieve anything, such as ending an epidemic like that of TB,” Raviglione said, about India’s aim to eliminate TB by 2025, five years ahead of the global target of 2030.

The Professor called on the need to boost rapid molecular testing. “It must be available at every point of care, it is essential for India to do much better than the progress achieved,” he said. Expanding its use can not only diagnose TB more rapidly but also boost the diagnosis of drug-resistant TB, which has a major implication. This will help in choosing the appropriate treatment. He also suggested, “campaigns of massive screening of the population to save lives because it will help detect TB cases early.” This may help the physicians decode whether the contacts of people with TB have been affected or must be given prophylaxis to safeguard them from the disease in the future. Further, to counter TB in India, he suggested the need to focus on social determinants such as undernutrition, smoking tobacco, alcoholism, poverty, air pollution, both indoor and outdoor; and a multi-sectoral approach.

The former WHO Director for TB also urged the need to tackle TB patients' suffering from “catastrophic expenditure.” “The cost of having tuberculosis is still very high, even if you have a country where the drugs are given free of cost like in India,” Raviglione said. He said this citing the diagnostic pathway opted by people, months before they get the correct diagnosis, and the treatment is initiated. “During that period, they visit several doctors, from modern medicine to Vedic medicine. So that means that they spend their money on several tests. For a person who lives under the poverty level, it becomes impossible to hold,” the Professor told IANS.