Experts urge 'comprehensive package' to fight TB

Noting that poverty and under- nutrition were among the "drivers" of tuberculosis (TB), the disease which claims 1.5 million lives globally every year, a study says that a "comprehensive package" of interventions is needed to combat it.
The new series of medical journal 'Lancet' has detailed a "scientific, therapeutic" plan to rapidly stop deaths from tuberculosis and change the disease's course "one community at a time".
The study led by Salmaan Keshavjee, Director of Harvard Centre for Global Health Delivery, and co-edited by Soumya Swaminathan, Director-General of the Indian Council of Medical Research (ICMR), says that the plan does not require a new breakthrough and, instead, requires better use of tools that already exist.

"Ending the global tuberculosis epidemic requires the urgent deployment of a comprehensive package of effective, tried and tested interventions in low-income and middle-income settings," said Keshavjee.
"Failure to seize this opportunity now will constitute both a scientific and a moral failure," he added.
Swaminathan, who stressed on the need to address the problem in an all-round manner, said, "While TB incidence rates in high- income countries are in single-digit numbers, these rates are still in the hundreds in many countries of Asia, Africa and Latin America.

"The drivers of TB include poverty, poor housing, under- nutrition and HIV infection, underscoring the need to address this problem holistically."

The series details a comprehensive strategy to quickly reach zero deaths from TB and to achieve the 2050 elimination targets more rapidly in high-burden settings while providing the scientific and social policy rationale for a comprehensive disease strategy.
The keys to the elimination plan include targeting hotspots of transmission, active case findings to identify infected individuals before they can transmit the disease to others, and prompt treatment of all forms of TB.
This comprehensive approach is in stark contrast to current piecemeal practices that often target only the most serious patients and provide incomplete therapies for those who do receive treatment.

The results have yielded steady but slow improvements in death rates, combined with a worrisome increase in drug- resistant strains of the disease, said Swaminathan.
"We have to hit this bug hard and hit it quickly. Cutting transmission in the community is key to the control of any infectious disease. Many cities in the world are seeing worrying increases in transmission of drug-resistant tuberculosis. All of us are vulnerable and, therefore, we must all act," Swaminathan said.