Editorial: Surge in TB cases

Under Nikshay Poshan Yojana an amount of Rs 500 is given every month to those diagnosed with TB which is grossly inadequate

Malnutrition is the culprit in many diseases. Tuberculosis, an infectious disease caused by bacteria, is one of them. In a country like India, where undernutrition is rampant, particularly among children, eradicating TB continues to be a major challenge. The link between diet and the fatal disease is well known. The latest review report of the Lancet Commission comes as a wake-up call for the healthcare authorities as it flags concerns over the surge in tuberculosis deaths across the world, from 1.4 million in 2019 to 1.6 million in 2021. What is alarming is that over half of them occurred in India, which accounted for 33% of deaths followed by Indonesia (10%) and Nigeria (8%). As per the Global TB Report 2022, India reported 5.04 lakh deaths in 2021 as against 5.52 lakh in 2010. The Lancet Commission has made a series of recommendations, including immediate scale-up in access to molecular diagnostics and AI-assisted chest x-ray technology. Its report has revealed that two-thirds of tuberculosis deaths occurred in just eight countries. While the Covid pandemic had an impact on the ability of global health systems to prevent, screen and treat TB, the report estimated that one-third of people were undiagnosed and untreated in 2022. The Lancet report comes at a time when a United Nations High Level Meeting on TB is scheduled to be held on September 22 and makes a strong case for focusing on a new menu of tools that has the potential to revolutionise TB prevention, diagnosis and treatment.

A good diet not only reduces the incidence of the disease among vulnerable people living with infected people, but it also brings down mortality in TB patients. Unequal access to economic opportunities, limited healthcare, poor sanitation, crowded living conditions, malnutrition and illnesses such as diabetes or HIV are all associated with increased risk of tuberculosis. In India, the National Tuberculosis Elimination Programme (NTEP) recognises the need to improve nutrition and under the ‘Nikshay Poshan Yojana’ an amount of Rs 500 is given every month to those diagnosed with TB. This is grossly inadequate to take care of the nutritional requirements. The NTEP guidelines recommend that a tuberculosis patient consume 2,800 calories every day. Nikshay Poshan is a half-hearted attempt at addressing one of the root causes of the problem. The scheme has also been dogged by systemic challenges. A 2020 study in the Indian Journal of Tuberculosis reported that healthcare providers complained of a lack of training and complex reporting formats as the main hurdles in the implementation of the scheme. Low patient awareness has also affected the nutritional programme’s reach. The government has plans to eliminate TB by 2025, a target considered by experts as too ambitious. Medical experts have all along underlined the need for a healthy diet of proteins, carbohydrates and micro-nutrients.