India, world failed to meet WHO End-TB milestone 2020, says Lancet study

: A new research published in The Lancet Infectious Diseases journal reveals that India’s tuberculosis (TB) incidence experienced only a marginal decrease of 0.5 per cent between 2015 and 2020, falling short of the World Health Organization’s (WHO) End-TB milestone for 2020.

The WHO’s End-TB strategy aims for a 90 per cent reduction in TB deaths and an 80 pee cent reduction in incidence rate by 2030, based on 2015 baseline figures.

However, India’s TB incidence rate remained high at 213 cases per one lakh population in 2020, surpassing the WHO’s milestone figure of 171 per one lakh population. Similarly, TB-related deaths in India ranged between 3.5-5 lakh in 2020, exceeding the mortality milestone of 2.7-3.2 lakh.

The study comes ahead of World Tuberculosis Day on March 24. Of the 204 countries analysed by the team, 15 met the 2020 TB incidence milestone, while 17 met the mortality milestone. Of the 15, 11 were in sub-Saharan Africa, the researchers forming the Global Burden Disease (GBD) 2021 Tuberculosis Collaborators said. Novel case-finding interventions in countries like Nigeria, Tanzania, Cameroon and Kenya helped reduce incidence, and were further supported by improved drug coverage in treating HIV across many countries in the sub-Saharan African region, they said.

An “efficacious, safe, and shorter” regimen for treating drug-resistant TB, endorsed by WHO, could have helped reduce deaths, they said. They were referring to the WHO’s updated recommendations on treating drug-resistant TB issued in 2020, amidst antibacterial resistance emerging as a major public health threat.

The team also acknowledged the efforts of national social protection interventions in Moldova and Ecuador - two of the 17 countries - that “markedly increased treatment adherence”, and “potentially prevented drug resistance”.

Around the world, children under 15 years of age were seen to have the largest reductions in TB burden, with incidence falling by 16 per cent and deaths by 34 per cent between 2015 and 2020, even as the burden still remains high in children, according to the authors.

Citing evidence from recent research, they said that most transmission of the bacterial disease happens outdoors. Thus, merging contact-tracing with community-based screening is crucial for

ongoing progress.