Stressing the urgent need to strengthen prevention efforts, Dr Ashok Bhardwaj, Chairperson of the National Task Force for Medical Colleges under the TB Mukt Bharat Abhiyaan, said, "We cannot end Tuberculosis (TB) in India unless we focus on the preventive strategy on priority."
Dr Bhardwaj, who is also the National President of the Indian Association of the Preventive and Social Medicine, was in Shimla to participate in the state programme on World TB Day recently. The 76 year old Preventive Medicine expert, who retired as Professor and Head from Government Medical college, Hamirpur in Himachal Pradesh, Dr Bhardwaj is associated with the TB programme for the last over two decades.
Speaking to News Arena Network during his visit to Shimla, Dr Bhardwaj said the fight against TB must extend beyond medical colleges to active community outreach.
"Monitoring of TB patients in the community has to be strengthened. Unfortunately, the performance in this regard in the field is not upto the mark. We need to gear it up," he said.
Dr Bhardwaj said as per official records, the TB deaths in India have been brought down from 28 deaths per lakh population in 2015 to 21 deaths per lakh population in 2024. "It’s a good figure when compared globally. Yet not satisfactory," he said.
He said the target was to bring down the fresh TB cases per lakh population to 47 by 2025 in India, but the figure achieved in 2025 was 187 fresh cases per lakh population.
He said the diagnostic tools for TB like CBNAAT (Cartridge Based Nucleic Acid Amplification Test) have increased manifold- from 250 in 2017 to 10,000 in the country. Himachal has 125 CBNAAT machines now and the state is doing well in the entire country with regard to end TB campaign.
However, stigma continues to be a major hurdle. Nearly 60 per cent of symptomatic individuals avoid testing, often due to social stigma — particularly among educated sections. Untreated lung TB patients can infect 10–15 persons annually, he warned.
Dr Bhardwaj said the second most important concern is that of asymptomatic TB. "As much as 42% of the population has asymptomatic TB and that can only be detected if we screen the vulnerable sections. But when the people having signs and symptoms of TB do not come out for treatment, it becomes all the more difficult to bring the asymptomatic population out for screening," he said.
The Chairperson said he had visited 329 medical colleges across the country and it was surprising that only 0.05 per cent people were referred from the OPDs (Out Patient Department) for TB testing in. From the OPD of 35000, one patient was referred for TB testing in one month, whereas this figure should be 10%.
He said anyone having 10 symptoms and eight vulnerable conditions including diabetic patients, smokers, immuno deficient patients etc defined in the TB programme should be mandatorily sent for TB screening. "But it is not being done in the medical colleges. It is largely not being done in indoor patients also," he said.
He said maximum TB deaths were occurring at home because of all these gaps. Most of the patients don't comply with the medication or are never identified for screening, which should be taken care of. He said Himachal, Pondicherry, Tamilnadu and Goa have shown good performance in bringing down TB deaths.
Dr Bhardwaj said Himachal Pradesh has not been a problem state so far as TB is concerned. Most interventions for TB eradication have been done seriously in Himachal Pradesh and the state has got results also. He said the cough syrup surveillance in HP is also yielding good results in reaching out to the TB patients. He said the fresh TB cases in Himachal at present were 14000 annually, dropping from 16000 per year in past some years.
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