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Year : 2021  |  Volume : 46  |  Issue : 2  |  Page : 359

IAPSM's efforts towards eliminating tuberculosis by 2025

Date of Web Publication29-May-2021

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DOI: 10.4103/0970-0218.317187

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How to cite this article:
. IAPSM's efforts towards eliminating tuberculosis by 2025. Indian J Community Med 2021;46:359

How to cite this URL:
. IAPSM's efforts towards eliminating tuberculosis by 2025. Indian J Community Med [serial online] 2021 [cited 2021 Jun 13];46:359. Available from: https://www.ijcm.org.in/text.asp?2021/46/2/359/317187

In India, tuberculosis continues to be a major public health problem, accounting for nearly quarter of the global tuberculosis (TB) burden. Through National TB Elimination Programme (NTEP), country has witnessed immense political and administrative commitment to eliminate tuberculosis by 2025, five years ahead of the global target. To achieve this, Central TB Division, Min. of Health & Family Welfare (MoHFW), Government of India (GoI) is adapting newer innovative strategies in its fight towards eliminating TB. One such strategy, is to assign “TB free status” to districts or states claiming reduction in TB (80% reduction in TB incidence from 2015). Since, it may take a longer duration for achieving TB free status, interim recognition is also considered as awards and certification of progress towards TB Free Status under bronze (20%), silver (40%) and gold (60%) categories. This aims to motivate, inspire and instil competitiveness in the mindset of the various stakeholders who are working for TB elimination in the districts or states. The process to assign “TB free status” claimed by districts or states includes systematic verification and evaluation of the claims by a technically competent third party agency. The MoHFW has identified Indian council of Medical Research - National Institute of Epidemiology (ICMR - NIE) and Indian Association of Preventive and Social Medicine (IAPSM) to jointly collaborate and conduct the verification process along with the World Health Organization (WHO).

In 2020, 1 state, 2 UTs and 72 districts claimed TB free status. IAPSM undertook the activity for the sub-national verification of TB free status during Jan - Mar 2021 in collaboration and coordination with ICMR-NIE, NTEP, IAPSM NTEP core team, WHO India, and Central TB Division, MoHFW, GoI. State and district nodal officers from medical colleges of the same or nearby districts were appointed who were trained with regards to claim verification process, supervision and monitoring and financial management of funds through online trainings. District TB officer identified survey teams (5/10/15 depending on the population of the district) and they were trained under the supervision of IAPSM nodal officers. The duration of survey activity in the districts ranged from 2-4 weeks. The nodal officers conduct supervisory activities through field visit and validated the findings. App based data entry by field teams and nodal officers.

Claim validation methodology includes (a) Verification of TB score: The key areas of TB score include TB case notification, detection of HIV status among TB patients, proportion of patients undergoing universal drug susceptibility testing, beneficiaries of Nikshay Poshan Yojna, drug resistant TB treatment initiation, children on chemoprophylaxis, financial expenditure, people living with HIV on Tuberculosis preventive treatment and others. District estimates for these are verified by nodal officers through secondary data available at the field. Random phone calls and visits to patients were done to ascertain and validate the records and reports. (b) Verification of drug sale data in public & private sector: The process includes gathering information on anti-TB drug sales in private sector and prescriptions with indication of anti-TB drugs in private sector through interviews. The nominal group technique and key informant interview is adapted to arrive at nearest estimates for the district. (c) Field survey to find number needed to test: The Incidence of TB based on date of diagnosis is calculated from field survey based on inverse sampling methods. The estimates provide the magnitude of under reporting in the district which is factored for the analysis of TB incidence.

As a result of these herculean tasks, many districts in the country were declared as TB-free by the Hon'ble Union Minister of Health and Family Welfare, at the World TB day on 24th March 2021. The efforts of IAPSM were applauded by Hon'ble Union Health Minister, MoHFW, ICMR, WHO and other stakeholders. The success of this first joint IAPSM-WHO-NTEP-ICMR collaboration has added more enthusiasm and energy among the public health professionals across India. This is a recurring annual activity till 2025 and we expect many more medical college faculty and budding post graduate students to continue the legacy in the coming years.

Best Professionals Award from Professional Association from Hon. Union Health Minister, being received by Dr. Ashok Bhardwaj for IAPSM on World TB Day 2021 at New Delhi.

IAPSM National NTEP Core team includes: Drs. Anil Purty, Ashok Bharadwaj, Bhavesh Modi, Roopali Bauroh, Sharath Burugina Nagaraja


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