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Indian government outlines plan to try to eliminate tuberculosis by 2020

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6604 (Published 03 November 2014) Cite this as: BMJ 2014;349:g6604
  1. Sanjeet Bagcchi
  1. 1Kolkata

India’s health minister, Harsh Vardhan, has announced that he hopes to eliminate tuberculosis in India by 2020. He was speaking at a global symposium run by the World Health Organization, called “Moving out of the box to end the global TB epidemic: with post-2015 strategy.”

The aim of the Indian campaign, which is called TB Mission 2020, is to provide free diagnosis and treatment to all patients with tuberculosis—whether in government or private hospitals—and to provide nutritional and financial support to patients.

“Drastic reduction demands we take bold steps, catching the bull by the horn,” said Vardhan. “We have already taken regulatory steps like banning commercial serology for TB diagnosis, bringing anti-TB drugs under a separate schedule of the national law on drugs to prevent misuse, and mandatory notification whenever a new TB case is detected,” he added.1

Experts have welcomed the initiative but pointed out that the country will need to overcome many problems to eliminate the disease. Santanu Das, consultant physician at the West Bengal Jeevanrekha Clinic, a centre that deals with a large number of patients with tuberculosis, told The BMJ that the main problems in eliminating tuberculosis were lack of awareness, poverty, and illiteracy.

“It has been observed that many patients do not take medicine timely, though these are provided free of cost,” said Das. Some patients stop taking antituberculosis drugs after the first few weeks because they notice an initial improvement and thus become careless about the full course of treatment; others take the drugs very irregularly.

“Ultimately all these [patients] turn into resistant cases of TB,” Das pointed out. He urged the government to spread awareness and education among patients with the disease.

Surendra K Sharma, professor and head of the department of medicine at the All India Institute of Medical Sciences in New Delhi, told The BMJ that eliminating tuberculosis from India was not impossible to achieve but would definitely be a challenge. Sharma said that a cross sector approach was needed, coordinated and led by the Ministry of Health and Family Welfare, with the involvement of several other ministries, including the environmental, education, labour, and urban and rural development ministries. “We will have to go into battle mode to achieve TB elimination, [by] launching a multipronged attack,” said Sharma.

However, Madhukar Pai, associate director of the McGill International TB Centre in Montreal, Canada, said, “My biggest concern is whether the TB Mission 2020 will actually get the budget that is required for its success.” He told The BMJ, “To engage the massive private sector, to improve quality of TB care, to provide rapid diagnosis and drug susceptibility testing to all, to scale up multidrug resistant TB treatment services, and to address problems like malnutrition, the Revised National TB Control Programme [India’s tuberculosis control initiative] will require a large budget.”

Pai added that the government should increase the budget for the programme and modernise the country’s DOTS (directly observed treatment, short course) programme.

Notes

Cite this as: BMJ 2014;349:g6604

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