THE GIST of Editorial for UPSC Exams : 28 October 2019 (A health warning (Indian Express))

A health warning (Indian Express)

Mains Paper 2: Health
Prelims level: Tuberculosis (TB) report
Mains level: Relation to Tuberculosis (TB) report with malnutrition

Context

The Annual India Tuberculosis (TB) report released by the government says that India is now home to about a quarter of the total global TB patients.
The current government is committed to ending TB in India by 2025.

TB in relations with Malnutrition and Sanitation

Prime Minister declared that rural India was open defecation free (ODF).
The Global Hunger Index 2019 put India at 102 in a list of 117 countries. India’s ranking was below Nepal, Bangladesh and Pakistan.
It has been established beyond doubt that TB is more of a social disease owing to its roots to poverty, malnutrition and poor sanitary conditions.

State of TB in India

The TB report reveals the progress on the government’s action plan on combating TB.
As per the report, 21.5 lakh TB cases were reported in the country in 2018. This is the highest number of TB cases registered in any country.
The report says that with the introduction of Nikshay – the computer-based surveillance programme for TB patients, the reporting of TB cases has improved dramatically.

Discuss the barriers to TB notifications

The working of such a surveillance programme in an unequal country like India should be taken with a pinch of salt.
In a paper published in the BMJ Open concluded that despite a national notification system of Nikshay other factors decide notification of patients.
Issues like patient confidentiality, poor knowledge of notification system, etc, prevented notification of TB patients in a hospital setting.
These factors are social and without intervening at that level, it is hard to believe that notification of TB cases can reach a significant number by 2025.
Of the total notifications, 5.4 lakh cases were from the private sector, an increase of 40% from last year. More than 80% of healthcare is now being delivered by private health enterprises.

Key issues in TB control for public health system

Public health

An increase in the notification of TB patients could be heartening for the government. But is not a good indicator for the public health system.

Hunger

The GHI report reminds that a hungry India cannot be free of TB.
Dietary deprivation is a direct indicator of inequality. Unequal societies cannot be made free of disease and infirmity.
BMC Pulmonary Medicine journal from Ethiopia shows that the proportion of malnutrition in TB patients was nearly 60%.
Even a very distal reason for malnutrition in the community became a proximal cause for TB.

Open Defecation

TB and sanitation have a direct causal relationship.
The Integrated Disease Surveillance Programme run by the National Centre for Disease Control maintains a web portal that details the outbreak of epidemics.
The validity of the claims of the Swachh Bharat Abhiyan (SAB) through this data shows that there was no statistically significant reduction in the occurrence of vector-borne epidemics in the country, two years after the launch of SAB.

Conclusion

To end TB is not possible till we end malnutrition, poverty and poor sanitation.
We need a paradigm shift in the response to TB. This should include a more sensitive approach on gender and towards the underprivileged.
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General Studies Pre. Cum Mains Study Materials

Prelims Questions:

Q.1) Which of the following best describes “International Everest Day”, which is being observed on May 29?
a) In memory of Bengali mathematician Radhanath Sikdar, who calculated the height of the tallest mountain known in the world.
b) In memory of the first summit of Mt. Everest by New Zealand’s Edmund Hillary and Nepalese Tenzing Norgay Sherpa.
c) A tribute to Sir George Everest on whose name the mountain was christened as ‘Everest’.
d) None of the above