India has set a target for complete elimination of TB by 2025, before the global target date of 2030 as announced by the Prime Minister Shri Narendra Modi in his inaugural address at the “the Delhi End TB Summit 2018”.
The Prime Minister expressed confidence that the Delhi End TB Summit would be a landmark event towards the complete elimination of TB. He has also asked all Chief Ministers to join in this campaign. In his speech, he acknowledged the role of frontline TB physicians and workers as a crucial part of the drive to eliminate TB and hailed the people afflicted with the disease “those patients who overcome this disease also inspire others”. He called for “multisectoral engagement and interventions” to achieve the desired target (PIB, Prime Ministers Office, March 13, 2018)
The Prime Minister launched Tuberculosis free India campaign on the occasion, to take forward the activities of the National Strategic Plan for Tuberculosis elimination (2017-2025) with its vision of a TB-Free India with zero deaths, disease and poverty due to tuberculosis. The four strategic pillars of NSP 2017-2025 to achieve Universal Access to quality TB diagnosis and treatment are “Detect – Treat – Prevent – Build” (DTPB).
The Summit has been jointly organized by the Ministry of Health & Family Welfare, SEARO (WHO South East Asia Regional Office) and the Stop TB Partnership.
TB is a preventable and curable disease. Yet, India has the highest burden of TB patients, including drug resistant patients in the world. MDR-TB is a public health emergency, not only for patients but also for doctors, who are at risk of acquiring the infection from their patients.
Recognizing this public health emergency, during my tenure as National President IMA, we had launched “GTN” as IMA End TB Strategy, where G stands for GeneXpert test (sputum diagnosis), T for Trace (contacts) and Treat. N is to Notify the disease at Nikshay (mandatory).
Every sputum should be tested with GeneXpert test to not only diagnose TB, but to also detect rifampicin resistance. Rifampicin resistance indicates primary MDR TB. Rifampicin resistance should be confirmed before starting ATT. The prevalence of MDR TB is more than 2% in primary TB cases.
All contacts of patients with infectious TB should be traced, screened and if required, treated with a full course of ATT. Early detection means early and better treatment, which will prevent further spread of TB.
WHO has defined a household contact as a person who has shared the same enclosed living space for one or more nights or for frequent or extended periods during the day with the index case during the 3 months before starting the current treatment. While, a close contact is a person who is not in the household but has shared an enclosed space, such as a social gathering place, workplace or facility, for extended periods during the day with the index case during the 3 months before commencement of the current treatment episode (Recommendations for investigating contacts of persons with infectious tuberculosis in low- and middle-income countries. WHO 2012).
Every doctor should register with Nikshay and report every TB case at nikshay.gov.in.
We stand alongside the Prime Minister, in his initiative to eliminate TB from the country by 2025.
I appeal to all doctors to participate wholeheartedly towards this end.
Dr KK Aggarwal
Padma Shri AwardeeVice President CMAAOGroup Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Immediate Past National President IMA