“Sisters and brothers,
I am indeed very pleased to address this National Conference on Women Winning against TB today, aimed at ushering in gender-sensitive and inclusive strategies and achieve ‘TB-Free India by 2025’.
My compliments to the Ministry of Health & Family Welfare and the Ministry of Women & Child Development for this important initiative! It is a testament to the government’s seriousness on TB elimination that we are meeting at a TB-related conference for the second time this year. I am happy this conference involves not only parliamentarians, but other public representatives, organizations working for TB elimination, women TB survivors, anganwadi workers, and others.
Sisters and brothers,
As we all are aware, tuberculosis remains one of the daunting global health challenges. It has claimed about 1.5 million lives in 2020. It affects millions more, causing a debilitating social and economic impact on their lives. Developing countries with large populations such as ours naturally have a high TB burden, posing a critical health challenge to our systems. According to WHO’s Global Tuberculosis Report 2020, India accounts for 26 percent of the global TB cases.
Given its wide-ranging impact, global initiatives such as WHO’s ‘End TB Strategy’ and UN Sustainable Development Goals and the UN General Assembly’s high-level meeting on TB have been significant. India too has put in place many flagship initiatives to make the country tuberculosis- free. Over the years, we have made steady progress in reducing the prevalence of the disease.
With a National Strategic Plan to End TB by 2025 (five years ahead of the SDG target), the government has come up with various initiatives under the National Tuberculosis Elimination Programme (NTEP). House-to-house Active Case Finding campaigns are being organized. We have substantially enhanced the availability of rapid molecular diagnostics at the block level, which has led to a 52% increase in the detection of drug-resistant TB. A web-based National TB Surveillance system called NIKSHAY has been developed and is being used by the public and private sectors. The nutritional status of the affected people is being improved through financial incentives under the ‘Nikshay Poshan Abhiyan’. Innovations in e-health are being used to reach people in remote rural areas. All these are excellent initiatives!
The drug-resistant TB -- both Multidrug-Resistant (MDR-TB) and Extensively Drug Resistant (XDR-TB) -- remains a major hurdle in our fight against the disease. However, I am confident we can beat TB by 2025 by adopting a fighting spirit and with the sustained efforts of our healthcare workers, scientists and officials,
It is well known that the impact of tuberculosis is disproportionately felt on the vulnerable sections of society. The high incidence of TB is found to have a positive correlation with poor air quality (outdoor and indoor), poor nutrition and lack of medical attention and care.
The effects of TB go beyond its physical impact. The disease causes substantial economic and social impacts on the lives of the people. Apart from the costs and side-effects of treatment, TB patients face unnecessary stigma from families, employers and society at large. This is totally unacceptable and must be stopped.
Although the disease is curable and preventable, the stigma attached to it makes it even more difficult to screen the disease at an early stage. You may be aware that in India, of the 26-lakh estimated new TB cases in 2020, 18 lakh were reported to the TB program – signifying a wide gap of 8 lakh between the estimated incidence and identified TB cases reported to the government.
While the prevalence of TB is higher among men than women, it can have a disproportionately high impact on women. The susceptibility of women to TB increases due to the fact that adequate priority is not given to their health, wellness and nutrition. I am told that TB has been responsible for the death of more women in the reproductive age group than all causes of maternal mortality combined. Facing the misery of abandonment and violence if found to have TB, it is not surprising that there are a large number of unreported and therefore untreated cases of TB amongst women.
Sisters and brothers,
It is thus very pertinent that we not only stay the course of TB elimination by 2025, but we must also address the disease and strengthen our systems from a gendered perspective. To that end, this conference is a tremendous opportunity to initiate a serious discussion on how to develop new strategies to alleviate the impact of TB on women.
Apart from offering better and structured counseling about the disease through health workers, better nutritional support through schemes like Nikshay Poshan Yojana must be arranged, paying particular attention to children, pregnant and postpartum women with TB.
States should take proactive steps to take up door-to-door screening, especially for women who may not be willing to approach healthcare systems on their own. But most importantly, there is also a great need for better awareness and advocacy programmes to change the social perception about tuberculosis.
The message should reach the people that TB is definitely preventable and curable. Lessons from other successful campaigns such as the Swachh Bharat Abhiyan should be taken.
We have seen some wonderful survivor stories today. We need to tap the strength of such women.
Sisters and brothers,
At a wider level, we need concerted action from all levels of the government if we have to achieve the ambitious target of eradicating TB by 2025. We need a massive mobilization of human, financial and technological resources and multi-sectoral interventions. We need to improve the nutritional status of people, need to do better contact screening, reduce out-of-pocket expenditure, have safety nets for the most vulnerable sections and detect TB better in hilly and remote areas.
In the time of pandemic, people have become aware of their lung health. It is gladdening to note that during the pandemic, the Health Ministry has adopted a bi-directional COVID-TB screening to improve case findings. In the same way, TB advocacy programmes should utilize this heightened awareness among people and spread the message about the disease.
Similarly, it should also be highlighted that there are several risk factors that could increase the chances of TB. Ultimately, people should become key partners in achieving our goal. More than any other disease, community engagement is vital to completely eliminate TB.
My dear fellow parliamentarians,
As elected representatives, you too are responsible for fulfilling this mission of TB Mukt Bharat by 2025. I encourage MPs, MLAs and Gram Pradhans to take regular district- and sub-district level reviews to ensure a gender-sensitive approach to TB eradication. I suggest greater convergence at district- and block-levels between the Ministries of Women and Child Development, Rural Development, Urban Development, and Health and Family Welfare. This can be achieved through a district-level joint task force on women and TB that provides supportive supervision and reviews at village and ward levels.
Apart from raising issues related to TB in the Parliament, MPs can also be catalysts in the mass awareness campaign in the fight against this disease by playing a proactive role in the public conversations.
Sisters and brothers,
I commend and applaud the Ministries of Women and Child Development, and Health and Family Welfare for coming together for the women affected by TB and to safeguard the lives and livelihoods of many.
A gender-responsive program through collaborative efforts will contribute hugely to achieving the goal of TB-free India.
India has achieved significant progress since Independence on various health indicators due to improved nutrition and increasing penetration of healthcare at the grassroots. TB is one of the unfinished items on the agenda and we have to collectively strive towards eliminating it.
The Central and State governments are showing much-needed intent about eliminating TB through concrete steps. We need to continue the same spirit of working together across party lines as Team India in our fight against TB.
Together we can and we will eliminate TB and work towards a healthy and disease-free India. TB Harega Desh Jeetega!
Thank you. Namaskar.