Experts urge more funds to tackle tuberculosis crisis

Why in news

Stating that tuberculosis (TB) has become a national crisis in India, the Health Ministry assured the TB community that eliminating the disease by 2025 had the ‘highest level of commitment from the Prime Minister Narendra Modi’s office.

Highlights

  • Nearly 4.2 lakh Indians die of TB every year. Out of the 10 million cases globally, India shoulders the maximum burden with 2.8 million cases. According to Health Ministry data, only 63% of the patients infected with the airborne disease are currently under treatment. Further, 1, 47,000 patients are resistant to first and second line TB medicines. At the current rate of progress, global targets to eliminate TB by 2030 will be missed by a 150 years.
  • Senior Health Ministry official Sunil Khaparde, who heads the TB programme voiced the assurance at the opening day of the 5th Global Forum on TB Vaccines in New Delhi.
  • Against this backdrop, Dr Soumya Swaminathan, deputy director general of the World Health Organisation (WHO) said that globally, governments need to invest more in TB research and development to meet the global targets.
  • WHO representative to India Hendrick Bekedam added that TB vaccine was a global public health good, which meant governments need to invest if they want to own it later.

What is tuberculosis

Tuberculosis (TB) is a multisystemic infectious disease caused by Mycobacterium tuberculosis (or TB), a rod-shaped bacterium. TB (TB may stand for the disease or the bacteria that cause the disease) is the most common cause of infectious disease-related mortality worldwide (about 10 million people worldwide were sick with TB in 2015, and about 1.8 million people died from TB worldwide in 2015 according to the World Health Organization [WHO]). HIV-associated TB infections are a leading cause of death in HIV patients. TB symptoms can span such a wide range that TB is termed the “great imitator” by many who study infectious diseases because TB symptoms can mimic many different diseases. Additional terms are used to describe TB. The terms include consumption, Pott’s disease, active, latent, pulmonary, cutaneous, and others (see the following section), and they appear in both medical and nonmedical publications. In most instances, the different terms refer to a specific type of TB with some unique symptoms or fin ings. The most common site (about 85%) for TB to develop is in the pulmonary tract. Humans are the only known hosts for Mycobacterium tuberculosis.

Key facts

  • Tuberculosis (TB) is one of the top 10 causes of death worldwide.
  • In 2016, 10.4 million people fell ill with TB, and 1.7 million died from the disease (including 0.4 million among people with HIV). Over 95% of TB deaths occur in low- and middle-income countries.
  • Seven countries account for 64% of the total, with India leading the count, followed by Indonesia, China, Philippines, Pakistan, Nigeria, and South Africa.
  • In 2016, an estimated 1 million children became ill with TB and 250 000 children died of TB (including children with HIV associated TB).
  • TB is a leading killer of HIV-positive people: in 2016, 40% of HIV deaths were due to TB.
  • Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat. WHO estimates that there were 600 000 new cases with resistance to rifampicin – the most effective first-line drug, of which 490 000 had MDR-TB. Globally, TB incidence is falling at about 2% per year. This needs to accelerate to a 4–5% annual decline to reach the 2020 milestones of the End TB Strategy.
  • An estimated 53 million lives were saved through TB diagnosis and treatment between 2000 and 2016.
  • Ending the TB epidemic by 2030 is among the health targets of the Sustainable Development Goals.

What are risk factors for tuberculosis

Although TB is not easily spread, it is usually spread between people who are in close contact (working together or living together).

There are many risk factors for developing tuberculosis. Certain groups of people have a high risk, such as people who work in hospitals and other areas where TB-infected people may reside (jails, nursing homes, group homes for HIV patients, homeless shelters). Close association with drug users, or people with known TB infections are also at higher risk. Other people at high risk include the following:

  • Visitors and immigrants from areas known to have high incidence of TB
  • Children and the elderly with weakened immune systems (especially those with a positive TB skin test, see below)
  • Patients with HIV infection
  • Drug abusers, especially IV drug abuse
  • Head and neck cancer patients
  • Transplant patients
  • Diabetics
  • Kidney disease patients
  • People undergoing immunosuppressive therapy
  • Silicosis

BCG vaccine

  • Bacillus Calmette–Guérin (BCG) vaccine is a vaccine primarily used against tuberculosis.
  • In countries where tuberculosis is common, one dose is recommended in healthy babies as close to the time of birth as possible. Babies with HIV/AIDS should not be vaccinated.
  • In areas where tuberculosis is not common, only children at high risk are typically immunized, while suspected cases of tuberculosis are individually tested for and treated.
  • Adults who do not have tuberculosis and have not been previously immunized but are frequently exposed to drug-resistant tuberculosis may be immunized as well.
  • The vaccine is also often used as part of the treatment of bladder cancer.
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