On World TB Day 2024, Dr Gunisha Pasricha, Principal Scientist, Infectious Disease Expert, MedGenome highlights that early diagnosis and precise drug resistance profiling are critical components of effective TB management. A range of tests, from conventional methods like smear microscopy to more sophisticated techniques like whole-genome sequencing, play pivotal roles in the diagnostics process
India’s battle against Tuberculosis (TB) stands as a testament to its focus on both resilience and innovation. The National TB Elimination Programme (NTEP), a centrally sponsored programme being implemented under the National Health Mission (NHM) has been focussing on its four strategic pillars- detect, treat, prevent and build. With a strategic multi-pronged approach, the nation is consistently approaching its ambitious goal of TB elimination by 2025. Being home to a significant proportion of global TB cases, India’s concerted efforts, driven by governmental initiatives, private sector collaboration, and community engagement, are reshaping the landscape of TB control and prevention.
Prevalence and urgency
TB remains a pressing global health concern, ranking as the 13th leading cause of death worldwide and the second leading cause from a single infectious agent, second only to COVID-19. Within this global context, India shoulders a considerable disease burden, with an estimated 21.4 Lakh TB cases reported in 2021, indicating 18 per cent increase compared to 2020 TB cases and 124000 (9.1/lakh population) MDR/RR-TB cases. With these disheartening statistics, MDR TB detection and controlling its spread is the need of the hour.
The imperative for testing
Early diagnosis and precise drug resistance profiling are critical components of effective TB management. A range of tests, from conventional methods like smear microscopy to more sophisticated techniques like whole-genome sequencing, play pivotal roles in the diagnostics process. Whole-genome sequencing can not only help detect TB but also identify mutations indicative of drug resistance, guiding clinicians in tailoring faster and targeted treatment regimens for optimal outcomes.
Government-private sector collaboration
The Indian government’s fight against TB emphasises outreach to marginalized communities, improved access to diagnostics and treatment, and fostering collaboration with the private sector. Private labs have also been working on developing affordable and faster alternatives for TB diagnosis, particularly for the drug-resistant strain identification. This collaboration towards a common cause extends to research initiatives as well. All efforts are aimed at refining drug susceptibility testing methods, thereby enhancing treatment efficacy and curbing resistance.
Community engagement and awareness
Community engagement remains central to TB control efforts, dispelling stigma, and fostering a culture of health-seeking behaviour. Grassroot awareness initiatives play a crucial role in educating communities about TB prevention, symptoms, and the importance of early diagnosis. Empowered communities are better equipped to navigate TB challenges and access timely care, contributing to the overall success of elimination efforts.
Challenges and opportunities
Despite significant progress, some challenges continue to persist. These include timely diagnosis, tracking and tracing, the lingering stigma, and uneven healthcare access. We need to continue our focus on innovation and resource allocation, ensuring the long-term viability of programs like NTEP, private sector contribution and the integration of cutting-edge techniques such as next-generation sequencing (NGS). Overcoming these challenges presents opportunities for refining strategies and accelerating progress towards TB elimination.
A beacon of hope
India’s journey towards TB elimination serves as a beacon of hope in the global fight against the disease. By leveraging technology, fostering public-private collaboration to scale testing efforts, awareness campaigns and empowering communities, India can reach the target for a future free from TB. As the nation inches closer to its 2025 goal, its experiences offer invaluable lessons and inspiration for countries worldwide grappling with TB, illuminating a path towards a healthier, TB-free world.
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