B D Sagar shouted out in Gujarati to a small collection of people sitting under a tree on a dusty hill, in the outer edge of Mehsana city, in north-western Gujarat. Sturdily built Sagar, a older treatment supervisor in Indias national tuberculosis (TB) programme, was searching for a TB patients in india, a tribal, called Khema Bhai Vanjara. A woman told Sagar that Khema Bhai had moved to another make-shift hut, five minutes away.
“If this had happened in the history, we would have had no idea where the patient is,” explained Sagar with poise, in Hindi, with a laptop bag sling over his shoulder. “Now I have two ways of finding the tb patients in india I can call on the mobile number registered in the system or, I can go to the registered doctor, and ask him to notify me when the patient comes back,” he said, as he sat on his black motorcycle, plastered with the words “Govt. of Gujarat”.
Sagar and Khema Bhai Vanjara are part of a direct programme in the district of Mehsana, about 80 km north of Ahmedabad, to provide TB patients in india treated in the confidential sector which handles about half of all TB patients in india cases nationwide-free medicines and counselling. In doing so, the programme hopes to address a major failing in India’s battle against a sickness that takes more than two lives every three minutes,
India has an estimated 2.8 million new cases of TB patients in india more than a quarter of the worldwide load every year. No more than 8.4 per cent of patients estimated to be treated in the private sector are registered with the government, leaving millions of India’s TB patients in india unmonitored, medicine regimens incomplete and the disease as persistent as ever.
In the second quarter of 2016, the private sector in Mehsana notified about 974 TB cases, more than 25 times the total number of cases registered in the first quarter of 2013 a mere 37 before the programme began.
The programme, initiated by the Central TB separation, part of India’s Ministry of Health and Family Welfare, attempts to connect private doctors to increase the number of TB patients in india registered with the public sector, and track the treatment conclusion of private sector patients. These patients are still treated within the private sector.
“Earlier the approach used to be: Why take care of those patients who don’t come to government system? Leave them,” said K.K. Patel, Mehsana’s district TB officer. “Now we try to reach them too.”
Replicating the programme across India could help better assess the real load of TB in India, but the national TB manage programme is short of funds to scale the programme nationwide. India’s national TB control programme received only about 50 per cent of the money it requested from the government in 2015-16, a trend that has sustained at least for the past four years, according to data from yearly reports of the programme. Funding patients from the private sector would boost the total cost to the government. The pilot programme in Mehsana is funded in part by the Bill and Melinda Gates base, but the financial support is unlikely to carry on after 2020.
By relying on public health system, India under-reports TB cases
India underestimates the load of TB by relying only on cases registered in the public sector, specialist view and two sub-national studies in its calculations, according to a 2014 World Health Organization (WHO) report. In its 2016 report,
But the success of the programme in Mehsana is greatly dependent on the work done by field officers, who act as the link flanked by the programme, chemists and private practitioners, in addition to counseling patients.