Lok Sabha Question No. 2095 (UNSTARRED), answered on 2023-12-15
Subject: WHO Global TB Report
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Amol Ramsing Kolhe, Supriya Sadanand Sule, DNV Senthilkumar. S., Kuldeep Rai Sharma, C.N. Annadurai, Subhash Ramrao Bhamre, Manjulata Mandal

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOK SABHA UNSTARRED QUESTION NO. 2095 TO BE ANSWERED ON 15 th DECEMBER, 2023

## WHOGLOBALTBREPORT

## 2095. DR. AMOLRAMSING KOLHE:

SHRIMATI SUPRIYA SULE:

DR. DNV SENTHILKUMAR S.:

SHRI KULDEEPRAI SHARMA:

SHRI C.N. ANNADURAI:

DR. SUBHASH RAMRAO BHAMRE:

SHRIMATI MANJULATAMANDAL:

Will the Minister of HEALTH AND FAMILYWELFARE be pleased to state:

- (a) whether as per WHO Global TB Report 2022 there has been a significant global recovery in the number of people diagnosed with Tuberculosis and under treatment in this regard;
- (b) if so, the details thereof and the response of the Government thereto;
- (c) the total number of tuberculosis cases reported in the country during the last three years, year-wise;
- (d) the challenges faced by the Government while implementing programmes for elimination of Tuberculosis in the country;
- (e) whether the Government is progressing towards achieving the target for elimination of Tuberculosis (TB) across the country by the year 2025;
- (f) if so, the details thereof and the achievements made in reduction of TB incidences and death rate in line with the target in the country; and
- (g) the details of the works carried out in the States of Rajasthan, Tamil Nadu, Maharashtra and Odisha under National Tuberculosis Elimination Programme?

## ANSWER

## THE MINISTER OFTHE STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a) to (g) As per the Global TB Report 2023, published by the World Health Organisation, there has been a global recovery in notification of TB cases and those initiated on treatment. India has been able to reach pre-COVID levels in TB case notification in 2022 itself. The total number of TB cases reported in Ni-kshay portal of the National TB Elimination Programme (NTEP) in the last 3 years and current year so far, are as under:

| Year                                             | 2020                                             | 2021                                             | 2022                                             | 2023*                                            |
|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|
| TB Notification                                  | 18.05 lakh                                       | 21.35 lakh                                       | 24.22 lakh                                       | 22.31 lakh                                       |
| *Source Ni-kshay (data till 30 th November,2023) | *Source Ni-kshay (data till 30 th November,2023) | *Source Ni-kshay (data till 30 th November,2023) | *Source Ni-kshay (data till 30 th November,2023) | *Source Ni-kshay (data till 30 th November,2023) |

As per the Global TB Report 2023, published by the World Health Organisation, the incidence rate of TB in India has shown a 16% decline from 237 per 100,000 population in 2015 to 199 per 100,000 population in 2022. During the same period, the TB mortality rate has shown a 18% decline from 28 per lakh population in 2015 to 23 per lakh population in 2022.

The key challenges faced by the Government in the implementation of the programme, include the following:

- a) latent TB infection in the community (31% of the population as per the National TB Prevalence Survey)
- b) social determinants of Tuberculosis beyond health
- c) health-seeking behaviour of the population due to lack of awareness and prevailing myths and misconceptions in the community.

To address these challenges and achieve SDGs related to TB by 2025, the National TB Elimination Programme (NTEP) implements a National Strategic Plan for TB Elimination (2017-25) across the country including the States of Rajasthan, Tamil Nadu, Maharashtra and Odisha. The key activities undertaken by the NTEP are as under:

- a. State and District Specific Strategic plan for targeted interventions in high-burden areas.
- b. Provision of free drugs and diagnostics to TB patients including for drug-resistant TB.
- c. Active TB case-finding campaign in key vulnerable and co-morbid populations.
- d. Integration with Ayushman Arogya Mandir to decentralize screening and treatment services closer to the community.
- e. Screening of vulnerable population during Ayushman Bhavah health camps through Ayushman Arogya Mandir.
- f. Private sector engagement including incentives for notification and management of TB cases.
- g. Scale up of molecular diagnostic laboratories to sub-district levels.
- h. Ni-kshay Poshan Yojana for nutritional support to TB patients.
- i. Intensified IEC campaigns to reduce stigma, raise community awareness and improve health seeking behaviour.
- j. Multi-sectoral response with involvement of line ministries.
- k. Scale up TB preventive therapy to contacts of pulmonary TB.
- l. Track notified TB cases through a case-based web-based portal namely Ni-kshay
- m. Pradhan Mantri TB Mukt Bharat Abhiyan (PMTBMBA):
14.  launched by the Ministry on 9th September 2022 for community support to TB patients with the objective to provide people with TB with additional nutritional, diagnostic and vocational support
15.  Ni-kshay 2.0 portal has been developed and made available in public domain for facilitating the community to register as Ni-kshay Mitra
16.  Guidance documents have been developed and shared with all State/UTs to implement the initiative
17.  Periodic reviews are done to monitor the progress of the initiative at National and State/UT levels

Further the details of work carried out in the States of Maharashtra, Rajasthan, Tamil Nadu, and Odisha under National Tuberculosis Elimination Programme is placed as Annexure-I.

*******

Under the National TB Elimination Programme (NTEP) free screening, free diagnostics and free drugs / treatment are provided across all public health facilities across the country including the States of Maharashtra, Rajasthan, Tamil Nadu, and Odisha. To provide services closer to the community, the TB screening services have been decentralized to the level of Ayushman Arogya Mandir. Intensive private sector engagement activities have been implemented as a result of which there has been a 7 times increase in the notification of TB cases. The molecular laboratories have been scaled up to cover all districts of the country along with treatment services for drug resistant TB in all districts.

The details of work done in the States of Maharashtra, Rajasthan, Tamil Nadu, and Odisha are as under:

## a) TB notifications

| State   | State   |   Maharashtra |   Odisha |   Rajasthan |   Tamil Nadu |
|---------|---------|---------------|----------|-------------|--------------|
|         | Private |         61022 |     5073 |       39528 |        16127 |
|         | Public  |         99413 |    40620 |       97701 |        54410 |
|         | Total   |        160435 |    45693 |      137229 |        70537 |
|         | Private |         86762 |     7119 |       45358 |        18068 |
|         | Public  |        111856 |    45378 |      104015 |        65079 |
|         | Total   |        198618 |    52497 |      149373 |        83147 |
|         | Private |        101355 |     9909 |       42648 |        22140 |
|         | Public  |        133548 |    50617 |      126898 |        72021 |
|         | Total   |        234903 |    60526 |      169546 |        94161 |
|         | Private |         87907 |     8628 |       35807 |        20756 |
|         | Public  |        103495 |    46001 |      107589 |        66340 |
|         | Total   |        191402 |    54629 |      143396 |        87096 |

Data source - Ni-kshay

## b) Treatment success rate (%)

| State/UT    | 2020   | 2021   | 2022   | 2023 (till Oct.)   |
|-------------|--------|--------|--------|--------------------|
| Maharashtra | 85%    | 86%    | 88%    | 86.30%             |
| Odisha      | 89%    | 89%    | 90%    | 90.80%             |
| Rajasthan   | 81%    | 83%    | 85%    | 86.60%             |
| Tamil Nadu  | 84%    | 83%    | 83%    | 85.20%             |

Data source - Ni-kshay