India’s fight against TB must also face off another enemy, HIV.
According to the India TB Report 2019, 21.5 lakh tuberculosis (TB) cases in India were registered with the Revised National Tuberculosis Control Programme (RNTCP) in 2018—a 16% increase from 2017. The rise is quite worrying—India already has the world’s largest TB burden—but, the data is a double whammy. The private sector, too, registered a 40% increase in cases reported from last year. One reason for this rise is the increase in number of HIV-infected individuals who developed TB. Persons living with HIV/AIDS (PLHA) are 21 times more likely to develop TB than others. Around 25% of deaths of PLHA have been attributed to TB. Given the co-infection, morbidity, and mortality of PLHA-TB, there is a need to tailor healthcare programmes for PLHA, and ensure better delivery.
India has the third highest HIV burden in the world (0.22% adult prevalence), and ranks second for HIV-associated TB (9% of cases worldwide). TB is the leading cause of deaths for PLHA; in India, nearly 50,000 of the 21.5 lakh PLHA—43,253 in 2017—had TB-HIV co-infection. The Union health ministry, taking heed of this co-infection, has launched the ‘TB Harega, Desh Jeetega’ campaign, the National TB Prevalence Survey, and an oral drug regimen for TB patients. Also, under the Nikshay Poshan Yojana, it provides direct benefit transfers to TB patients for nutritional support. However, many TB patients—around eight lakh—going unregistered is a big hurdle; the problem worsens when a patient is also HIV-infected. The government must, therefore, step up efforts to get all TB cases registered with the RNTCP.