India can curb TB deaths by 28% over the next 30 years: Lancet

NEW DELHI: India can avert around 28% of tuberculosis related deaths over the next 30 years by subsidising tests and supporting patients to complete treatment, a latest report by Lancet Commission says.

The Commission estimates show there are significant financial benefits of reducing TB mortality with the savings from averting a TB death estimated to be three times the costs, and may be much greater in many countries. In India, subsidising tests and supporting complete treatment is projected to cost an extra $290 million each year, which is significantly less than India’s $32 billion losses associated with TB mortality each year.

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, which are cases that are not notified and most remain either undiagnosed or inadequately diagnosed and treated in the private sector.

Untreated or partially-treated TB patients may infect others, at least partially nullifying India’s attempts to end the disease and jeopardise the country’s ambitious target of eliminating TB by 2025.

Modelling commissioned for the report assessed how greater private sector engagement in a high-burden country like India, where private providers offer extended capability, could affect tuberculosis incidence and mortality.

The private sector handles an estimated two-thirds of India’s 2.74 million new TB cases--the highest TB burden in the world – and better TB diagnosis and care in the private sector can help India eliminate the burden faster.

“India’s National Strategic Plan for Tuberculosis Elimination (2017–25) commits to a large expansion of private provider engagement and calls for a six-time increase in private notifications to 2 million patients per year by 2020, which would represent 75% of the estimated tuberculosis incidence. If India’s plan succeeds, it will be the first major high-burden country with a dominant private health-care sector to align its tuberculosis programme with the care-seeking patterns of its population,” the Commission said ahead of the World TB Day on March 24th .

Globally, 1.6 million deaths were recorded from TB in 2017.

In India, treatment for TB includes a 6-month course of medicines, freely provided by the government’s Revised National Tuberculosis Control Programme (RNTCP).

Last year, India made it a punishable offence for doctors and diagnostic labs to not report TB cases. TB was made notifiable in 2012, but compliance has been low so far.