Need to scale-up TB screening, recommends Parl committee

New Delhi The Parliamentary Standing Committee on health and family welfare suggested simple-to-use and less time-consuming diagnostic methods to considerably scale-up tuberculosis (TB) screening in the country, in its recent report.

The step will be crucial in India achieving its TB elimination target of 2025, five years ahead of the global target of 2030 under the sustainable development goals (SDGs), as it would result in cases getting identified and put on treatment in time so that disease transmission is halted.

“…Being cognizant of the challenges being faced in TB control, the Committee had suggested that the government develop a “diagnostic method that is very simple to use and less time-consuming that frontline workers can use to get results within minutes at minimal costs…” read the committee report that was tabled in parliament in the Budget session earlier this month.

Union health ministry, in its response, said that the department of health research and Indian Council for Medical Research (ICMR) has established an India TB Research Consortium for working on research and development on TB drugs, diagnostics, vaccines, and implementation research.

“The ICMR has also constituted a committee of experts for identifying innovations for conducting feasibility studies based on the readiness of the products…. Newer diagnostic methods as and when recommended by the ICMR are incorporated into the programme guidelines based on feasibility of adoption and scalability,” said the health ministry in its response that is documented in the committee report.

The committee also raised concerns about the lack of dedicated TB wards and treatment facilities, noting that some major tertiary hospitals lacked dedicated TB wards. It also had concerns about allocation of resources and its effective utilisation to ensure quality standards and treatment protocols are followed. Among the recommendations was to launch nationwide awareness campaigns to promote acceptability of TB treatment.

Additionally, the government, the report said, should collaborate with pharmaceutical companies to negotiate for better price of TB drugs through bulk purchasing or licensing agreements. The Committee also suggested the government to “establish an arrangement with fixed accountability to maintain a regular supply of quality TB medications ton all parts of the country.

The health ministry in its response clarified that the health system was being continuously supported to further expand the in-patient care required for TB patients both for drug sensitive and drug-resistant TB.

“DR-TB centres have been established in all districts with beds wherever required for admission of TB patients. The Ayushman Arogya Mandir centres are actively involved in providing TB services. These centres have dedicated a day every month “Ni-kshay Diwas” focused on providing TB care for all existing TB patients, IEC & awareness activities in the community and screening of vulnerable activities through community outreach,” it said in its response.

On the availability of drug, the ministry said that it continuously engaged with the relevant pharmaceutical companies to ensure price reduction and the principles of GFR are followed for all public procurements under the National TB Elimination Programme.

“The Ministry has always encouraged domestic pharmaceutical industry for manufacturing Anti TB Drugs. For ensuring access to DR-TB drugs to the patients seeking care in the private sector, the programme has laid down SOPs for the state and districts by which private sector can engage with the programme for easy access to the newer drugs free of cost.”

According to the Global TB Report by the WHO, India has seen a decline of 16% in TB incidence (new cases emerging each year) and a 18% reduction in mortality due to TB, since 2015. The incidence rate in India has fallen from 237 per 100,000 population in 2015 to 199 per 100,000 population in 2022. During the same period, the global TB incidence has shown a decline of 9% and mortality by 18%.