Taking a leaf out of the HIV/AIDS control strategy, the government’s tuberculosis (TB) elimination programme will focus on reaching out to women, transgenders and vulnerable populations that fall through the cracks because of discrimination in access to treatment.
With a TB elimination target of 2025, five years ahead of the global target of 2030, the health ministry has renamed the National TB ‘control’ programme as TB ‘elimination’ programme, and adopted gender-sensitive and gender-specific interventions.
“The programme has been renamed to highlight the government’s focus on TB elimination compared to the earlier focus on TB control. The approach is now more focused towards filling the gaps and taking examples from other successful programmes on how best to implement the learnings in the TB programme,” said Kuldeep Sachdeva, deputy director general, TB.
The primary effort is to sensitise frontline workers in the district, state and even national level on issues pertaining to vulnerable populations, especially gender sensitivity, and how to deal with it. “The key is change in mindsets and behaviour of all stakeholders, including programme managers, healthcare providers, staff in the public and private sector, who are providing services to people with TB, civil society and community leaders…,” according to the revised framework.
The revised plan is in line with the 2018 United Nations General Assembly resolution on TB, to which India is a signatory, which recognizes socio-cultural barriers to TB prevention, diagnosis and treatment services, especially for those who are vulnerable or are in vulnerable situations, and the need to develop integrated, people-centred, community-based and gender-responsive health services based on human rights.
{{/usCountry}}The revised plan is in line with the 2018 United Nations General Assembly resolution on TB, to which India is a signatory, which recognizes socio-cultural barriers to TB prevention, diagnosis and treatment services, especially for those who are vulnerable or are in vulnerable situations, and the need to develop integrated, people-centred, community-based and gender-responsive health services based on human rights.
{{/usCountry}}TB affects an estimated 10 million people globally every year, of which around 3.2 million are women. An estimated 1.6 million people die of TB every year, of whom 0.84 million are men and 0.5 million are women. An estimated 3.6 million people with TB are not reported to health systems across the world.
India has the highest annual incidence of TB in the world as well as the highest TB-related mortality. An estimated one million cases of TB go unreported in India every year. More than one million women and girls are diagnosed with TB in India every year.
A higher proportion of the 27.4 lakh diagnosed with TB in India are men and the ratio of men to women is 2:1 (Global TB Report 2018).
Although more men are affected by TB, women experience the disease differently. Gender differences and inequalities play a significant role in how men and women access and receive healthcare in public and private sectors.
While the fear of loss of income and the consequences of absence from work hinder care seeking in men, women face difficulties due to perceived stigma, prioritisation of household chores, lack of money or financial dependence.
Poor health literacy and fear of criminalisation hinders transgender persons from seeking care.