6 June 2024

GS 2 – Social Justice : Health

Tuberculosis (TB)

• Tuberculosis (TB) is a bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person.
• It mainly affects the lungs, but it can affect any part of the body, including the tummy (abdomen), glands, bones and nervous system.
• TB is a potentially serious condition, but it can be cured if it's treated with the right antibiotics.

Types of TB

• Pulmonary TB –

• TB that affects the lungs (pulmonary TB) is the most contagious type, but it usually only spreads after prolonged exposure to someone with the illness.
• In most healthy people, the body's natural defence against infection and illness (the immune system) kills the bacteria and there are no symptoms.

• Latent TB –

• Sometimes the immune system cannot kill the bacteria, but manages to prevent it spreading in the body.
• You will not have any symptoms, but the bacteria will remain in your body. This is known as latent TB.
• People with latent TB are not infectious to others.

• Active TB –

• If the immune system fails to kill or contain the infection, it can spread within the lungs or other parts of the body and symptoms will develop within a few weeks or months. This is known as active TB.
• About one-quarter of the world’s population is estimated to be infected by TB bacteria but out of these only 5-15% of people will fall ill with active TB disease.
• Latent TB could develop into an active TB disease at a later date, particularly if your immune system becomes weakened.

 Treatment for TB

• With treatment, TB can almost always be cured.
• A course of antibiotics will usually need to be taken for 6 -18 months.
• Several different antibiotics are used because some forms of TB are resistant to certain antibiotics.

 TB in India

• The total number of incident TB patients (new and relapse) notified during 2021 in India were 19.33 lakh as opposed to that of 16.28 lakh in 2020.
• In 2022, 24.22 lakh case s of TB were registered in the country.
• India continues to have the largest share of the global TB burden.
• India’s National TB Elimination Programme is strengthened to meet the goal of ending the TB epidemic by 2025 from the country, five years ahead of the Sustainable Development Goals (SDG) for 2030.
• The National Strategic Plan for Tuberculosis Elimination (2017-2025) was developed to achieve the goal.
• Though the National Strategic Plan for Tuberculosis Elimination (2017-2025) outlined a paradigm shift in approach and strategy to achieve the ambitious goal, by 2020, it became clear that the NSP will not be able to meet these objectives.
• A new National Strategic Plan for Tuberculosis Elimination (2020-2025) to end TB was launched.

Reasons for high prevalence of TB in India:

Tuberculosis (TB):

• Tuberculosis is a contagious bacterial infection caused by Mycobacterium tuberculosis.
• It primarily affects the lungs but can also affect other parts of the body. Symptoms include coughing, chest pain, weight loss, and fatigue.
• TB is spread through the air when an infected person coughs or sneezes, making it highly contagious.
• Treatment usually involves a combination of antibiotics taken over several months.

Reasons for High Tuberculosis Prevalence in India:

• Population Density: India’s large population and high population density contribute to the spread of TB.
• Poor Healthcare Infrastructure: Limited access to healthcare facilities and diagnostic services hinder early detection and treatment.
• Poverty and Malnutrition: Socioeconomic factors such as poverty and malnutrition weaken immune systems, increasing susceptibility to TB.
• Limited Awareness: Lack of awareness about TB symptoms, transmission, and treatment options delays diagnosis and treatment initiation.
• Overcrowded Living Conditions: Overcrowded housing and poor ventilation increase the risk of TB transmission.
• Drug Resistance: Inadequate treatment adherence and misuse of antibiotics contribute to the emergence of drug-resistant TB strains.
• HIV/AIDS Epidemic: The HIV/AIDS epidemic exacerbates TB prevalence, as HIV weakens the immune system, making individuals more susceptible to TB infection.
• Migration and Urbanization: Rural-to-urban migration and urban slum populations facilitate TB transmission due to overcrowding and poor living conditions.

What are the Steps to be Taken to Mitigate the TB Crisis?

• Prioritising the Needs and Interests of Patients and Communities:

• The needs and the interests of patients and communities must be prioritised within the care paradigm and the health-care system.
• This principle, echoed by survivors, communities, health experts and policymakers, underscores the need for a person-centred approach to TB care and management.

• Following an Individual-Centric Approach:

• The rise of influential advocates among TB survivors who have vigorously pushed for the inclusion of affected communities’ needs in discussions.
• They have advocated for changes in various areas, leading governments to adjust their approaches to meet these community needs.
• For example, there has been some progress in providing nutritional support, albeit limited, which marks a significant advancement.

• Bridge the Gap Between Policy Intent and Ground Realities:

• There is a need to bridge the gap between policy intent and on-the-ground realities. For instance, India needs to prioritise targeted interventions aimed at improving and expanding access to TB diagnosis and treatment.
• TB testing facilities must be expanded, particularly in rural and underserved areas, and ensure the availability of free, affordable and quality-assured TB drugs.
• Molecular testing is the gold standard and less than a quarter of symptomatic patients are getting that as their first test.

• Making TB Care More Humane:

• Efforts are needed to strengthen community-based TB care models, empowering frontline health-care workers to deliver comprehensive care which addresses not just treatment but also social, economic and mental health needs and is closer to where patients live.
• This is important as survivor narratives tell us the stigma, discrimination and mental stress they go through, not to mention the side-effects of treatment.

• Adopting a Multi-Sectoral Approach:

• Addressing the socio-economic determinants of TB requires a multi-sectoral approach. Poverty alleviation, improvement in nutritional status, well-ventilated housing and better air quality will all contribute towards reducing TB.
• By tackling the underlying root causes of TB, India can make significant strides towards eliminating the disease and improving the overall health and well-being of its population.

• Tapping Technology:

• Leveraging technology and innovation holds promise in enhancing TB care efforts in India. The adoption of AI and digital health solutions for TB diagnosis, adherence and surveillance can revolutionise the way TB care is delivered and accessed in the country. By investing in developing better vaccines, we can hope to ultimately eliminate this airborne disease.
• X-ray technology has advanced dramatically. Now, we not only have portable hand-held devices, but also software driven by AI that can read digital X-ray images and detect possible TB with a high degree of certainty.

GS 3 : Science and Technology

Astrophysicists are grappling with the mystery of why galaxies rotate faster than predicted by Newton’s laws.This has led to debates between the existence of dark matter and alternative theories like Milgromian dynamics (MOND).Recent research challenges Milgromian dynamics (MOND), reinforcing the dark matter hypothesis.