Need for Age-responsive TB care in India

India’s elderly population is increasing due to advances in healthcare and longer life expectancy.
In 2011, 9% of India’s population was over 60, expected to rise to 12.5% by 2030.
Older individuals often face challenges in getting timely TB diagnoses and managing the disease due to comorbidities.
Tuberculosis (TB) affects over 25 lakh Indians annually and kills at least 1,000 people every day.
The prevalence of TB among people over 55 is much higher than the national average.

TB symptoms are often mistaken for signs of old age, leading to delayed or missed diagnoses.
Management is complicated by comorbidities, leading to irregular treatment adherence and poor outcomes.
Older people may experience reduced “will to live” due to lack of social and emotional support.
Access to healthcare services, reliable health information, and nutritious food is limited for older individuals.
Many elderly individuals rely on savings or family support and may lose economic independence.
Further, limited social welfare schemes are available for the elderly.
TB-related stigma and ageism contribute to mental health challenges, loneliness, and anxiety.

Building Age-Responsive TB Care

Investment in the health and unique needs of the elderly is crucial.
Holistic care models are needed to reduce the need for elderly individuals to interact with multiple healthcare providers.
Health professionals need better training in understanding and managing TB in the elderly with comorbidities.
Improved case-finding methods for the elderly, including mobile diagnostic vans and active case finding in geriatric settings.

Protocols and support for the elderly

Develop technical and operational protocols for diagnosing and treating TB in the elderly.
Implement support protocols, such as elder-focused community care models, doorstep delivery of medicines, and peer support.
Strengthen data collection and analysis for elderly TB cases and collaboration within the healthcare system.
Establish a research agenda focused on TB in the elderly to understand trends, drug resistance, co-morbidities, and equity issues.
Investigate intersectionality with gender, disability, class, and caste in elderly TB cases.

TB is an infectious disease caused by Mycobacterium tuberculosis.
It primarily affects the lungs but can impact other body parts.
It is treatable and curable.
Transmission occurs through the air when infected individuals cough, sneeze, or spit.
Common symptoms include cough with sputum, chest pains, weakness, weight loss, fever, and night sweats.
The Bacille Calmette-Guérin (BCG) vaccine is used to prevent TB.
In 2020, 1.5 million people died from TB, and 10 million fell ill with the disease globally.

TB in India

India has the highest TB burden in the world.
Approximately 26 lakh people contract TB, and about 4 lakh die from it annually in India.
Challenges in controlling TB in India include poor rural healthcare infrastructure, unregulated private healthcare practices, poverty, lack of political will, and corruption.

Pradhan Mantri TB Mukt Bharat Abhiyan

An initiative by the Ministry of Health and Family Welfare (MOHFW) to eliminate TB in India by 2025.
Objectives include improving treatment outcomes, involving communities, and leveraging Corporate Social Responsibility (CSR).
Components include the Ni-kshay Mitra Initiative for additional support and the Ni-kshay Digital Portal for community involvement.

Other initiatives:

Global Efforts

WHO’s “Find. Treat. All. #EndTB” initiative with the Global Fund and Stop TB Partnership.
WHO releases the Global Tuberculosis Report.

India’s Efforts

National TB Elimination Programme aims to end TB by 2025.
National Strategic Plan (NSP) for Tuberculosis Elimination (2017-2025).
Nikshay Ecosystem (National TB information system).
Nikshay Poshan Yojana (NPY) provides financial support to TB patients.
TB Harega Desh Jeetega Campaign.
Development and clinical trials of TB vaccines VPM 1002 and MIP.
Ayushman Bharat Digital Health Mission for digital health IDs and improved diagnostics for TB patients.

AMIGOS IAS