The way to control tuberculosis

• Tuberculosis is worst among endemic diseases, killing 1.5 million people every year (WHO).

TB And India

• India: TB capital of the world, it kills some 1,400 persons every day.
• These are gross estimates, for our health management system has no method to count the exact numbers.
• The National TB Control Programme of 1962 was district-based with public-private participation.
• However, upscaling the model proved unsuccessful and the programme failed to control TB.

Flaws in the programme

• No prescribed method of monitoring trajectory of TB control.
• Assumption that treating pulmonary TB patients alone would control TB was epidemiologically fallacious in India.
• RNTCP failed to elicit people’s partnership in TB control.

Controlling TB

• Human mastery over microbes includes control, elimination and eradication.
• Control refers to the reduction of disease burden through specific interventions to a predetermined level in a pre-stated time period.
• Evidence will have to show that reduction was due to those interventions and not due to a ‘secular trend’.

Conclusion

• Elimination refers to achieving zero frequency of new cases.
• As we have a huge backlog of latent TB, we cannot eliminate TB, but we must aim for a high level of control and document it with measurement.

Prelims Take Away

• TB
• AIDS
• National TB Control Programme