Tuberculosis (TB) is a serious public health issue in India, with historically only two-thirds of those suffering from the illness benefitting from government schemes. As a matter of concern, one such plan is the Union government’s Nikshay Poshan Yojana (NPY), a solitary nutrition support program. This article aims to shed light on TB, NPY, and pertinent efforts to combat the fatal disease.
Understanding Tuberculosis
TB is an ancient infectious illness, caused by the bacterium Mycobacterium Tuberculosis. This pathogen belongs to the Mycobacteriaceae family which consists of about 200 members, some of which cause diseases like TB and Leprosy. Humans most commonly contract pulmonary TB that affects the lungs, however, it can also affect other body organs, known as extra-pulmonary TB. The disease spreads through air when individuals with lung TB cough, sneeze or spit, thereby propelling the TB germs into the air. TB symptoms include chronic cough with occasional blood in sputum, chest pains, weakness, weight loss, fever and night sweats. Importantly, tuberculosis is treatable with a standard 6-month course of four antimicrobial drugs supervised by health professionals.
Nikshay Poshan Yojna Explained
The NPY, formulated by the Ministry of Health and Family Welfare in 2018, provides a Direct Benefit Transfer of Rs 500 per month to each TB patient to support their nutritional needs. It has circulated around Rs 1,488 crore to 5.73 million notified beneficiaries since its inception. The reported performance of the scheme in 2021 was that merely 62.1% of 2.1 million notified cases throughout the country received at least one payment. Disappointing statistics were noted in Delhi, Punjab, Jharkhand, Maharashtra, Bihar, Rajasthan and Uttar Pradesh, with the poorest results seen in the northeastern states of Manipur and Meghalaya. The implementation faced various hurdles, including non-availability and unlinked bank accounts, lack of communication, stigma, illiteracy and a multi-step approval process.
The Status of TB in India
The India TB Report 2022 revealed that the total number of TB patients rose to more than 1.9 million in 2021, marking a 19% increase from 1.6 million in 2020. Simultaneously, the mortality rate due to all kinds of tuberculosis increased by 11% between 2019 and 2020. Factors like malnutrition, HIV, diabetes, alcoholism, and tobacco smoking were identified as comorbidities exacerbating the impact of TB on afflicted individuals.
Initiatives to Combat TB
Efforts to combat TB involve both global initiatives and strategies unique to India. The WHO, the Global Fund, and Stop TB Partnership launched the “Find. Treat. All. #EndTB” initiative and release the annual Global Tuberculosis Report. India has its range of schemes: the National Strategic Plan (NSP) for Tuberculosis Elimination (2017-2025), The Nikshay Ecosystem (a national TB information system), Nikshay Poshan Yojana (for financial support), and the TB Harega Desh Jeetega Campaign. Additionally, two vaccines—VPM (Vaccine Projekt Management) 1002 and MIP (Mycobacterium Indicus Pranii)—are currently being tested in a Phase-3 clinical trial.
A Broader Approach Needed
India has set an ambitious target to eliminate TB by 2025. However, experts posit that to achieve this, a broader approach encompassing more than just medical aspects is vital. The government must critically examine system bottlenecks and inefficient scheme roll-outs instead of injecting funds into a failing structure. As TB affects primarily the impoverished community, crippling families due to medical costs and lost wages, food support schemes for at-risk individuals in close contact with patients could prove instrumental in disease prevention.
