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27.9 lakh Indians infected with TB in 2016; 8.5 lakh cases gone unreported: WHO report

India is trying to eliminate tuberculosis by 2025

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India tops the list of countries with highest number of patients infected by Tuberculosis with an estimated 27.9 lakh patients reeling under TB in 2016 and upto 4.23 lakh patients have been estimated to have died. 
Ambitious announcements of wiping out tuberculosis from India by 2025 apart, projections in World Health Organization’s (WHO) annual TB report 2017 released on Monday, look dismal for the nation.  

India has the largest burden of TB cases in the world. The report states, “The five countries that stood out as having the largest number of incident cases in 2016 were India, Indonesia, China, the Philippines and Pakistan.”

Up to 27.9 lakh patients were estimated to be infected with TB in India last year. The infection burden in China is one third of India at 8.95 lakh even as it is more populous than India. Indonesia has a large number of TB patients at an estimated 10.2 lakh. Phillipines and Pakistan have close to over five lakh estimated TB patients. 

Of the 27.9 lakh estimated patients, only 19,38,158 TB cases were notified in public and private sector in India, which means that over 8.5 lakh cases are slipping out of the treatment purview. India aims at eliminating TB by 2025, which means bringing down incidence to less than one case per 1,00,000 people. The current incidence in India is 211 cases per 1,00,000 , according to the report. 

The report 2017 further estimates that 1,47,000 patients in India were grappling with multi-drug resistant TB - that in which the first line drugs of Rifampacin, Isoniazid, Ethambutol and Pyrazinamide do not work. However, the Indian government has records of only 37,258 MDR-TB patients, which means that over a lakh drug-resistant patients are going untreated. 

Ten countries including India accounted for 75% of the incidence-treatment enrolment gap for drug-resistant TB. India and China accounted for 39% of the global gap, says the report. 

Despite of National Strategic Plan of India aiming to make Bedaquiline, a drug used to treat MDR-TB available at 140 sites, it is currently given to only a handful, only 728 people in all of India, in six sites are receiving the life saving drug. The gap in availibility of drug to needy patients is huge. 

Ten countries accounted for 76% of the total gap between TB incidence and reported cases. Not only does India have the highest number of TB cases in the world, but it also infamously figures in top three countries of these ten countries, wherein the gap between estimated TB incidence and reported cases is the highest - India (25%), Indonesia (16%) and Nigeria (8%). 

Globally, in 2016, 63 lakh new cases of TB were reported (up from 61 lakh in 2015), equivalent to 61% of the estimated incidence of 1.04 crore cases. Close to 40% TB cases in the world go unreported, according to WHO. Of the 1.04 crore estimated cases, over half of them hail from India, Indonesia, China, Phillipines and Pakistan. 

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