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EDITORIAL ANALYSIS : A new edge to the fight against tuberculosis

             

Source: The Hindu, The Hindu

 

  • Prelims: Current events of national importance(AMR,TB, National TB Elimination Programme, Covid-19, Mission COVID Suraksha etc
  • Mains GS Paper II: Government policies and interventions for development in various sectors and issues arising out of their design and implementations etc

 

ARTICLE HIGHLIGHTS

  • At the One World TB Summit in Varanasi, Uttar Pradesh Prime Minister instilled fresh energy to the global tuberculosis (TB) elimination response and reiterated India’s commitment to spearhead this effort.

         

INSIGHTS ON THE ISSUE

Context

Tuberculosis:

 

  • TB is caused by a bacterium called Mycobacterium tuberculosis, belonging to the Mycobacteriaceae family consisting of about 200 members.
  • Some of Mycobacteria cause diseases like TB and Leprosy in humans and others infect a wide range of animals.
  • In humans, TB most commonly affects the lungs (pulmonary TB), but it can also affect other organs (extra-pulmonary TB).
  • TB is a treatable and curable disease.
  • TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air.
  • Common symptoms of active lung TB are cough with sputum and blood at times, chest pains, weakness, weight loss, fever and night sweats.

 

PM’s emphasis during the TB summit:

  • Importance of innovation
  • The need to “find new ways and formulate new strategies” to achieve the desired outcomes.

 

Lessons from the COVID-19 response:

  • Drawing upon the innate human spirit to adapt, learn, experiment, and innovate.
  • The pandemic has shown us that together, we can overcome unprecedented adversity.

 

Progress to end TB:

  • India’s National TB Elimination Programme or NTEP: has introduced several measures to find, notify and treat TB cases.
    • Case notifications rising from 6(fifteen point six)lakh in 2014 to over 24 lakh in 2022.
      • This reflects the programme’s expanded reach and improved detection measures.
    • Engagement with the private sector
    • Launch of social support provisions
    • Introduction of diagnostic tools and new drug regimens.
    • The Mission COVID Suraksha programme to develop vaccines was a good example of a public-private partnership, with clear goals and outcomes.
    • The huge number of diagnostic tests developed
    • Variety of different vaccine platforms

 

Challenges:

  • Lack of widespread awareness about the disease
  • Lack of access to quality care continues
  • The National TB Prevalence Survey (in India) found that 64% of people with infectious TB did not seek care.
  • National-level estimates suggest that for every person notified with TB, we miss detecting almost two more cases.

 

How to address challenges and  bring transformative change in our TB response efforts?

  • Introduce disruptive approaches and new tools to change the way we prevent, diagnose, and treat TB.
  • Importance of investing in health research and development(especially in recent years).
  • Establishment of centers of excellence, which will facilitate collaboration between Indian Council of Medical Research laboratories and the private sector.
  • Strengthen and expand research and development efforts for TB
    • To develop new tools that will help India (and other developing countries) meet the End TB targets.

 

Steps Needed:

  • Bacille Calmette-Guérin (BCG) vaccine for TB, it does not adequately protect adolescents and adults who are at the highest risk for developing and spreading TB.
    • Prioritize and pick up the pace to find an effective TB vaccine.
  • There are currently over 15 TB vaccine candidates in the pipeline
    • Ensure that their clinical trials are prioritized to assess their efficacy in various community settings and for different target groups.
  • Testing for, and diagnosing TB needs to become more accessible and affordable.
    • Each person with suggestive symptoms or frontline worker can test and get results within minutes, at minimal costs.
  • Point-of-Care Tests (POCTs), such as home-based tests for COVID: It allowed decentralized, rapid and low-cost diagnostics to provide results within minutes.
    • New innovations such as nasal and tongue swab-based tests for TB can reduce diagnostic delays.
  • Handheld digital x-ray machines (with artificial intelligence-based software) can now be taken to villages and urban settlements to screen large numbers of high risk individuals, safely and conveniently.
  • The development and introduction of new therapeutic molecules can play a crucial role in the long run.
  • Continuing to invest in drug discovery
  • Scale up newer and more effective regimens and also dip into our armory to repurpose existing drugs for TB.
  • Strengthening the innovation ecosystem by creating regulatory and policy frameworks that smoothen the rollout of proven tools to reach people with as little delay as possible.
    • This requires greater collaboration between
    • policymakers
    • scientists
    • product developers and clinical researchers across the country and even across regions,
    • potentially between governments.
  • Harmonization of standards and regulatory processes between countries can enable mutual recognition of evidence-based standards and licenses and save critical time towards rollout.

 

Initiatives:

 

Way Forward.

  • The COVID-19 pandemic proved India’s apt title: pharmacy of the world.
    • Our scientific ingenuity during the pandemic has cemented our position as pioneers in innovation in the life sciences.
  • We must create a strong platform that channelises investments in research to bring in a paradigm shift at every stage of the TB care cascade — prevention, testing, and treatment.
  • With its G-20 presidency, India has another historical opportunity to build a global health architecture that creates equitable access for all.
  • Call for the collaborative development of transformational tools and approaches that cater to not only our own needs but also that of the under-represented but disproportionately affected developing world.
  • TB should no longer be the leading infectious disease killer globally, in the 21st century, and India can lead the way.

 

QUESTION FOR PRACTICE

Critically examine the role of WHO in providing global health security during the COVID-19 Pandemic.(UPSC 2020) (200 WORDS, 10 MARKS)