Tuberculosis: Challenges and overview
India is home to the highest number of TB cases in the world. Annually about 4.23 lakh individuals including around 100,000 children die due to TB costing the country a staggering $23.7 billion. About 40% of the Indian population are latently infected with TB and face the risk of contracting the disease during their lifetime.
The current treatment for TB is lengthy and complex, often leading to treatment interruptions resulting in complications. Delayed diagnosis and inadequate treatment further exacerbate the risk. The growing threat of drug resistant tuberculosis, compounds the problem. Around 147,000 cases of multi-drug resistant TB are reported from India annually with only 33% of such patients surviving treatment.
Sustained efforts by the Government of India (GoI) have led to a decline in the number of TB cases. The Revised National Tuberculosis Control Programme – responsible for driving the five-year TB National Strategic Plans – has reached over a billion individuals in 632 districts/reporting units using the WHO recommended Directly Observed Treatment Short Course strategy. Greater surveillance had led to an increase in case detection while improved drug managed had resulted in a dip in mortality from 480,000 to 423,000 in 2016.
However, more needs to be done to achieve the GoI's objective of eradicating TB by 2025.
Malaria: Challenges and overview
Malaria remains a major public health problem. As per the National Vector Borne Disease Control Programme, 1.13 million malaria cases were reported in 2015. Around 1.5 million confirmed cases are reported annually, which is 68% of all malaria cases in the WHO's Southeast Asia region.
The disease is particularly entrenched in low-income rural areas. According to a study, the National Framework of Malaria Elimination in India 2016-2030, malaria results in $2.67 direct out of pocket expense at household level and loss of 3.4 working days with an indirect cost of nearly $10.85.
Malaria is preventable. Malaria is completely curable, provided effective treatment is started early. However, delay in diagnosis and treatment can lead to serious consequences including death.
The GoI is committed to eradicating malaria by 2027. The National Vector Borne Disease Control Programme has led to a decline in malaria cases being reported and arrested the number of deaths to around 1000 per year. Despite the achievements, the burden and the risk of malaria are enormous.