The government of India is all set to organise a mega India TB summit from March 13-16. All chief ministers will be invited and Prime Minister Narendra Modi will inaugurate the first of its kind event which is aimed at generating sufficient momentum for his vision of a TB free India by 2025, five years ahead of the global TB elimination target of 2030.
While the prime minister’s office has confirmed his participation on the first day of the high profile event, the presence of several other global figures in India around that time – including WHO Secretary General Tedros Ghebreyesus – raises the possibility of the presence of not just the WHO boss but also India’s export to the global health behemoth, WHO DDG Dr Soumya Swaminathan who has a special professional interest in TB.
During the summit, PM Modi is also expected to formally launch the National Strategic Plan for TB Elimination 2017-25 (NSP) which was unveiled last year. Though some of the key features of the plan are already in place, the ministry is hoping that a formal launch by the prime minister would give an additional impetus to the programme on the ground.
Late last year, PM Modi had written a letter to all the chief ministers of the country asking them to hold “at least” quarterly reviews of the TB control programme in order to meet the elimination target. “There are about 29 lakh new TB cases every year and about 4.20 lakh people, mostly poor, are estimated to die annually on account of TB, leaving lakhs of children orphaned. Economic loss on account of TB in India is estimated to be about Rs 20,000 crore per annum. We cannot allow such human tragedies for a disease which is treatable and for which drugs and diagnostics are available in the public healthcare system,” PM Modi had written at the start of his letter.
TB kills an estimated 480,000 Indians every year and more than 1,400 every day. India also has more than a million ‘missing’ cases every year that are not notified and most remain either undiagnosed or unaccountably and inadequately diagnosed and treated in the private sector. This despite the fact that India as a nation has been engaged in TB control for over 50 years now.
Crafted in line with World Health Organization’s (WHO) End TB Strategy, and the Sustainable Development Goals (SDGs) of the United Nations (UN), the key features of NSP are to effectively address patients seeking care in private sector, including provision for free medicines, augmentation of availability of rapid molecular tests, a nutritional support to TB patients in DBT mode – Rs 500 per month has already been cleared by the expenditure finance committee – and an India TB Control Foundation.
For the incentives that will be given to all TB patients for the duration of the treatment irrespective of income levels, the total annual expenditure sanctioned by the committee of the department of expenditure is Rs 900 crore for 26 lakh patients.
Health ministry sources say all senior government ministers including Finance Minister Arun Jaitley, Home Minister Rajnath Singh, Women and Child Development Minister Maneka Gandhi and Drinking Water and Sanitation Minister Uma Bharti will be invited for the summit. Incidentally, even before its formal and expectedly high profile launch, NSP suffered a setback last year when the budget estimate in the NSP was pared by Rs 4000 crore. The TB elimination plan was finally allocated Rs 12000 crore instead of the Rs 16000 crore requirement envisaged in the NSP.
Interestingly, a joint monitoring committee set up for the purpose of evaluating the TB programme had singled out fund constraint as a major challenge. The strategic plan too recognises that fact when it says: “The JMM 2015 observed that the implementation of the NSP for 2012-2017 did not achieve the projected increase in case detection by the RNTCP. In addition, the ambitious expansion of resources planned under the NSP, 2012-2017 will have tripled the expenditure of the prior plan but has not been matched by allocations. While RNTCP expenditure has increased 27 per cent since 2012, there is a growing gap between the allocation of funds and the minimum investment required to reach the goals of the plan.”