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Critical Topics and Their Significance for the UPSC CSE Examination on January 24, 2025

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India’s winding road to ‘#EndTB’

For Preliminary Examination:  Current events of national and international importance

For Mains Examination: GS II - Governance

Read about:

Drug-Resistant TB

World TB Day

Key takeaways:

• Last year, tuberculosis (TB) once again became the leading cause of infectious disease-related deaths worldwide. The ambitious "End TB" goals, aiming for a 90% reduction in TB-related deaths, an 80% reduction in new TB cases, and the elimination of catastrophic costs for families affected by TB by 2030, seem increasingly out of reach. In 2018, India committed to achieving these targets by 2025, with accelerated efforts. However, the COVID-19 pandemic has severely hindered progress.
• The World Health Organization's 2024 Global Tuberculosis Report highlights India as the nation with the highest TB burden, accounting for 26% of global cases, and also as a central hub for drug-resistant TB (DR-TB) and TB-related deaths.
• While the government has rolled out numerous policies and initiatives to tackle TB at the national level, it is critical to understand the on-the-ground challenges in India to ensure that these initiatives lead to effective interventions.

Addressing Vulnerable Groups

• India’s National Tuberculosis Elimination Programme (NTEP) has identified high-risk groups that are more likely to contract TB and experience severe outcomes. Dr. Pavitra Mohan, a pediatrician and founder of Basic Healthcare Services, an NGO working in rural Rajasthan, states that her clinics see around 1,000 TB patients annually.
• Many of these individuals suffer from severe lung damage due to inhaling fine dust in mining and stone carving industries. Factors such as silicosis, malnutrition, overcrowding, and unmanaged co-morbidities like diabetes further increase their risk of contracting TB.
• Migrant workers, who face poor access to healthcare, also struggle with treatment adherence, as they often return to their home regions when ill, complicating the healthcare system's ability to track their progress.
• While much focus is being placed on addressing malnutrition among TB patients, other contributing factors—specific to each region—need to be tackled, requiring a multi-sectoral approach.
• TB is a curable disease, and NTEP provides effective, free treatments. India has achieved a notable milestone in initiating treatment for over 95% of notified cases, thanks to the establishment of a dedicated procurement and supply chain system for the NTEP.
• However, in 2023, a nationwide disruption in the supply chain has led to continued shortages of essential medicines in many parts of the country. This shortage has caused significant distress for patients, many of whom have to buy drugs from external sources, resulting in catastrophic health-related expenses.
• Nandita Venkatesan, a data journalist and two-time TB survivor, highlights the severe consequences of treatment interruptions. Such disruptions risk the development of drug-resistant TB and contribute to poor health outcomes.

Challenges with Extrapulmonary TB

• Extrapulmonary TB (EP-TB), which affects organs outside the lungs, such as lymph nodes, kidneys, brain, spine, bones, joints, and skin, poses additional challenges. The NTEP primarily focuses on pulmonary TB, as it is the most common and contagious form.
• However, EP-TB accounts for about 24% of all TB cases, with substantial geographical variation. EP-TB is often delayed or missed in diagnosis due to its non-specific sym