5 Questions: Rakesh Sinha on progress of TB elimination programme

"India has one-fourth of the world’s TB cases. And we realised the gravity of the situation in 2017 when the Prime Minister set the target of eliminating TB by 2025," says nominated MP Rakesh Sinha.

Nominated MP Rakesh Sinha (File)

Nominated MP Rakesh Sinha on Tuesday raised a question on the progress of the country’s TB elimination programme. He spoke to Anonna Dutt.

What made you raise the question?

India has one-fourth of the world’s TB cases. And we realised the gravity of the situation in 2017 when the Prime Minister set the target of eliminating TB by 2025. That became a benchmark and the entire machinery started working on tuberculosis. That’s when a holistic approach for TB elimination started and there is a need to focus on extra-pulmonary TB (TB outside the lungs) as well.

What are the issues surrounding extra-pulmonary TB?

I consulted many people and found that in rural areas when someone has extra-pulmonary TB… like in the stomach, brain, or bone… and they go to the doctor… if their lungs are clear they are not diagnosed with TB. Therefore diagnosis happens at the fag end of the disease. Then I consulted doctors and found out the entire focus of the programme is on the lungs.

What needs to be done?

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It is a question of medical governance. With the cases of extra-pulmonary TB rising (it increased from 26% of all reported TB cases in 2019 to 29% till May 31 2022, as per data tabled in Parliament), such people (experts on non-pulmonary TB) need to be included in policy making, programme implementation and in peripheral health centres. Even at the level of diagnosis, we have to change the approach.

What has changed since 2017?

Before the programme started, we did not know the exact number of TB patients in the country. After 2017, it became mandatory to report all TB cases. A link has been established between patients, doctors, and hospitals. The private sector has been brought into the folds. And diagnostics are reaching the periphery.

Can we eliminate TB by 2025?

The Covid-19 pandemic in the last two years disturbed the programme, but we still have three years to go. With dedicated work, nothing is impossible. There is a need to identify the patients, treat them, and localise them or limit their travel and interaction. The peripheral healthcare system needs to be strengthened, doctors who can treat extra-pulmonary TB need to be increased, and pharmacies need to report people who come to get the medicine so cases are not missed. Timely, proper treatment can stop drug-resistance.

Anonna Dutt

Anonna Dutt is a Principal Correspondent who writes primarily on health at the Indian Express. She reports on myriad topics ranging from the growing burden of non-communicable diseases such as diabetes and hypertension to the problems with pervasive infectious conditions. She reported on the government’s management of the Covid-19 pandemic and closely followed the vaccination programme. Her stories have resulted in the city government investing in high-end tests for the poor and acknowledging errors in their official reports. Dutt also takes a keen interest in the country’s space programme and has written on key missions like Chandrayaan 2 and 3, Aditya L1, and Gaganyaan. She was among the first batch of eleven media fellows with RBM Partnership to End Malaria. She was also selected to participate in the short-term programme on early childhood reporting at Columbia University’s Dart Centre. Dutt has a Bachelor’s Degree from the Symbiosis Institute of Media and Communication, Pune and a PG Diploma from the Asian College of Journalism, Chennai. She started her reporting career with the Hindustan Times. When not at work, she tries to appease the Duolingo owl with her French skills and sometimes takes to the dance floor. ... Read More

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