Pradhan Mantri TB Mukt Bharat Abhiyaan

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• Recently, the President of India launched the `Pradhan Mantri TB Mukt Bharat Abhiyaan’.

Pradhan Mantri TB Mukt Bharat Abhiyaan

• Vision: 
  • It has been envisioned to bring together all community stakeholders to support those on TB treatment and accelerate the country’s progress towards TB elimination.
  • This is aimed at working towards TB elimination from the country by 2025.
• Components of the scheme: 
  • The Ni-kshay Mitra initiative which forms a vital component of the `Abhiyaan’ is also launched along with the Abhiyaan. 
  • This portal provides a platform for donors to provide various forms of support to those undergoing TB treatment. 
  • The three-pronged support includes:
    • Nutritional, 
    • Additional diagnostic, and 
    • Vocational support. 
• Adoption Provision for Corporates and NGOs:
  • Under the scheme, individuals, NGOs and corporates can adopt TB patients by committing support for 1-3 years. 
  • To join the initiative, they have to register on the site, which has an anonymous list of TB patients, categorized according to the primary health centres, blocks, districts and states. 
  • The sponsors can select the number of patients as per their capacity.
• Monthly Food Basket: 

Image Courtesy: IE 

Significance

• Vocational Training: The sponsors may offer vocational training to family members of the TB patient. 
• Financial support: Most of the TB patients are breadwinners, and this puts financial strain on their families. If a family member is trained in a vocation, they will be able to continue earning.

Tuberculosis (TB)

• Number of cases: 
  • India detects 20-25 lakh TB cases every year, and nearly 4 lakhs die of it. At present, 13.5 lakh are undergoing TB treatment, of whom 9.26 lakh have already consented to being adopted under the initiative.
• Cause:
  • It is caused by Mycobacterium tuberculosis (bacteria) and it most often affects the lungs.
• Transmission:
  • TB is spread through the air when people with lung TB cough, sneeze or spit. 
  • A person needs to inhale only a few germs to become infected.
  • With TB infection, a person gets infected with TB bacteria that lie inactive in the body. This infection can develop into TB disease if their immune system weakens. 
• Symptoms:
  • Prolonged cough, chest pain, weakness/fatigue, weight loss, fever, etc.
  • Often, these symptoms will be mild for many months, thus leading to delays in seeking care and increasing the risk of spreading the infection to others.
  • Most people have the TB bacteria in the body but it gets activated if nutrition is poor and the immune system is impaired. 
• Diagnosis:
  • In the case of suspected lung TB disease, a sputum sample is collected for testing for TB bacteria.
  • For non-lung TB disease, samples of affected body fluids and tissue can be tested.
  • WHO recommends rapid molecular diagnostic tests as initial tests for people showing signs and symptoms of TB.
  • Other diagnostic tools can include sputum smear microscopy and chest X-rays.
• Treatment:
  • Both TB infection and disease are curable using antibiotics.
  • It is treated by the standard 6-month course of 4 antibiotics. Common drugs include rifampicin and isoniazid.
  • In drug-resistant TB, the TB bacteria do not respond to the standard drugs. Its treatment is longer and more complex. It is treated by Bedaquiline.
  • In case of infection (where the patient is infected with TB bacteria but not ill), TB preventive treatment can be given to stop the onset of disease. This treatment uses the same drugs for a shorter time.

Challenges

• Drug resistance: Adherence to TB medication for several months is a challenge, but, if not done, can lead to drug resistant forms of the disease (XDR TB). 
• Proper diagnosis:  Many people in rural areas have extra-pulmonary TB in the stomach, brain, or bone. If their lungs are clear they are not diagnosed with TB. Therefore, diagnosis happens at the end of the disease.
• Experts on non-pulmonary TB are not included in policy making, programme implementation and in peripheral health centers.

Efforts Taken

• Global Efforts:
  • Global Tuberculosis Programme and Report, 1+1 initiative & Multisectoral Accountability Framework for TB by WHO.
  • Ending the TB epidemic by 2030 under UN SDG target 3.3.
  • Moscow Declaration to End TB.
• Indian Efforts:
  • The government aims to have a TB-free India by 2025, five years ahead of the global target of 2030.
  • National Tuberculosis Elimination Programme: National Strategic Plan to end TB by 2025 under pillars of Detect-Treat-Prevent-Build (DTPB).
  • Universal Immunisation Programme.
  • Revised National TB Control Programme under the National Health Mission.
  • NIKSHAY portal and TB Sample Transport Network.
  • Development of National Framework for Gender-Responsive approach to TB.

Way Ahead

• The programme will provide the much-needed nutritional support to the people and will also connect the community.
• 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 and proper treatment can stop drug-resistance.

Source: IE