Tuberculosis, commonly known as TB, is caused by the bacterium Mycobacterium tuberculosis, and primarily affects the lungs. TB is highly contagious and spreads through the air when an infected person coughs, sneezes or talks. According to the World Health Organization (WHO), a total of 1.6 million people died from TB in 2021 (including 187 000 people with HIV). Worldwide, TB is the 13th leading cause of death and the second leading infectious killer after COVID-19 (above HIV/AIDS).
Jammu and Kashmir has been one of the most affected regions by TB, with a high burden of the disease and a large number of multi-drug resistant TB cases. However, the region has made significant progress towards TB elimination in recent years, with a remarkable milestone achieved in 2022.
Kashmir’s journey towards TB elimination began with the launch of the Revised National TB Control Program (RNTCP) in 1997. The program aimed to provide universal access to quality TB diagnosis and treatment services, and it has been successful in reducing the burden of the disease in the region.
In 2018, Jammu and Kashmir launched a comprehensive TB elimination program, which included a robust surveillance system, increased public awareness, and a focus on improving access to quality care for all TB patients. The program also emphasized the importance of collaboration between the public and private health sectors to achieve TB elimination.
One of the key strategies of the program was to provide free TB diagnosis and treatment services to all patients, including those who seek care from private healthcare providers. This approach helped to ensure that all TB patients receive quality care, regardless of their socioeconomic status.
Another critical aspect of the program was the use of new and innovative technologies, such as GeneXpert machines, which provide rapid and accurate diagnosis of TB and drug resistance. The program also leveraged mobile health (mHealth) technologies to improve the tracking and monitoring of TB patients, which helped to ensure that they completed their treatment.
The efforts of Jammu and Kashmir’s TB elimination program have paid off, with the region achieving a remarkable milestone in 2022. According to the state’s health department, in 2022, Kashmir division reported 3376 TB cases, Srinagar district reported 1465 cases, followed by Anantnag district with 665 cases, Baramulla registered 599 TB cases, Kupwara district reported 361 cases, Pulwama 172 cases and Budgam district reported 114 TB cases.
Recently, two more districts in Kashmir were declared as tuberculosis (TB) free. With this Kashmir division has three TB free districts which include Budgam, Anantnag and Pulwama.
Besides that, Srinagar has got a gold medal under sub-national TB certification.
There are four kinds of acknowledgment for meeting case reduction objectives, with TB-free status representing an 80 percent reduction taking the top rank.
The other categories are gold medal (over 60 percent reduction), silver medal (over 40 percent reduction), and bronze medal (over 20 percent reduction).
Earlier, Secretary Health and Medical Education, Bhupinder Kumar had said that the UT Government is fully committed to achieve the ambitious target of elimination of TB by 2025, ahead of the national target of 2030 under Pradhan Mantri TB Mukht Bharat Abhiyan (PMTBMBA).
This achievement is a testament to the dedication and hard work of the healthcare workers, policymakers, and community members involved in the program. It also demonstrates that TB elimination is possible, even in resource-constrained settings, with the right strategies and interventions.
However, the fight against TB is far from over, and sustaining this progress will require continued investment and commitment. There is a need to further strengthen the healthcare system and build the capacity of healthcare workers to ensure that TB patients receive quality care.
There is also a need to address the social determinants of TB, such as poverty, malnutrition, and overcrowding, which can increase the risk of TB transmission and impede treatment outcomes. Addressing these underlying factors will require a multisectoral approach, involving not only the health sector but also other sectors such as housing, education, and social welfare.
Jammu and Kashmir’s achievement in TB elimination is a remarkable milestone in public health, and it provides hope and inspiration to other regions that are grappling with the burden of the disease. However, it is also a reminder that the fight against TB requires sustained effort and investment, and it is a collective responsibility that requires the involvement of all stakeholders.
Although elimination of Tuberculosis is one of the sustainable development targets to be achieved by 2030 by the world, India has set the target of 2025. The national strategic plan 2017-2025 sets the target of India reporting no more than 44 new TB cases or 65 total cases per lakh population by 2025. The estimated TB incidence for the year 2021 stood at 210 per lakh population.
Achieving this target is a big task as the plan had envisaged an incidence of only 77 cases per lakh population by 2023.
The programme also aims to reduce the mortality to 3 deaths per lakh population by 2025. The estimated TB mortality for the year 2020 stood at 37 per lakh population.
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The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.