Why in the News?

India’s progress towards achieving its goal of eliminating tuberculosis (TB) by 2025 has come under scrutiny due to significant challenges in meeting TB detection targets. Despite the implementation of National Strategic Plans and efforts to transition from smear microscopy to molecular tests, the country is still struggling to bridge the gap between the set objectives and the current reality.

Introduction

Tuberculosis (TB) remains a significant public health challenge for India, and the nation’s commitment to eliminating this disease by 2025 is facing obstacles. The National Strategic Plan (NSP) was launched to guide the efforts to combat TB, with a focus on precision diagnostics and efficient detection methods. However, the transition from traditional smear microscopy to advanced molecular tests presents challenges that need urgent attention.

What is TB?

Tuberculosis, commonly referred to as TB, is a highly infectious bacterial disease caused by Mycobacterium tuberculosis. It primarily affects the lungs but can also impact other parts of the body. TB transmission occurs through the air when infected individuals cough, sneeze, or talk.

What is the National Strategic Plan (NSP)?

The National Strategic Plan (NSP) for TB is a comprehensive framework designed to guide India’s efforts in achieving the ambitious goal of eliminating TB by 2025. It outlines strategies, targets, and action plans for various aspects of TB control, including diagnostics, treatment, prevention, and awareness.

What is Smear Microscopy?

Smear microscopy is a traditional diagnostic technique used to detect TB. It involves examining sputum samples under a microscope to identify the presence of TB bacteria. While it has been a valuable tool, its limitations in terms of sensitivity and accuracy have prompted the shift towards more advanced diagnostic methods.

What is NAAT-based Molecular Test?

NAAT-based molecular tests, such as nucleic acid amplification tests, are advanced diagnostic tools that detect the genetic material of TB bacteria. These tests offer higher sensitivity and quicker results compared to smear microscopy, enabling early and accurate diagnosis.

Challenges in Transitioning to Molecular Testing

• Limited Resources: The availability of molecular testing machines is limited, hindering the rapid transition from smear microscopy to molecular tests.
• Shortage of Trained Personnel: Skilled professionals are required to operate advanced diagnostic tools, but a shortage of trained personnel poses a challenge.
• Scarcity of Molecular Tests: The availability of molecular tests remains scarce, further impeding the transition process.

Role of Private Sector Collaboration

To expedite the transition to molecular testing and meet the 2025 goal, collaboration with the private sector is pivotal. Utilizing the private sector’s capacity for molecular testing can significantly increase the availability of advanced diagnostic services.

Importance of Bacteriological Confirmation

Bacteriological confirmation of TB cases is essential for accurate diagnosis. However, in 2022, a significant proportion of notified TB patients lacked bacteriological confirmation, indicating a reliance on alternative diagnostic methods like X-rays and clinical evaluation.

Management of Drug-Resistant TB

Universal drug-susceptibility testing is vital for identifying drug-resistant TB cases early. The revised NSP emphasizes the importance of providing “universal access” to drug resistance testing, aiming to curb the spread of drug-resistant strains.

Conclusion and Way Forward

India’s path to TB elimination by 2025 faces substantial challenges in terms of diagnostics and detection. While the NSP and revised strategies lay out comprehensive plans, their successful implementation hinges on addressing the obstacles hindering the transition to molecular testing. Collaborative efforts with the private sector, bolstering resources, and expanding access to advanced diagnostics are imperative to achieving the goal of a TB-free India.

Read More: Challenges in Achieving India’s TB Detection Goals