New Delhi: Declaring that tuberculosis (TB) in India cannot be eliminated by the government alone, the Union ministry of health and family welfare has asked state governments to involve the private sector to tackle the problem.

Reviewing the National Health Mission, C.K. Mishra, secretary, Union health ministry, said on Monday, “States should co-opt the private sector as elimination of TB is not possible otherwise."

Recently, a proposal from NITI Aayog echoed the same notion.

“Health is a state subject. As per the proposal of NITI Aayog, we have asked the states if they want to involve private sector for eliminating TB. Private sector can help in several ways ranging from diagnosis to treatment of TB," said Mishra.

The government has realised that the private sector has played a significant role in managing TB patients.

The annual TB Report 2017 released by the Union health ministry earlier this year revealed that in 2016, with the help of NIKSHAY (a web-enabled application developed by National Informatics Centre) to monitor Revised National Tuberculosis Programme (RNTCP) effectively, the program reported that almost one-fifth of TB patients were from private healthcare facilities.

“Since TB has been made a notifiable disease, more than 1,13,961 private health establishments are registered under NIKSHAY till December 2016. Among them, 70,146 are private practitioners and clinics, 34,105 are hospitals, clinics, nursing homes and 9,710 are laboratories," the report stated.

“Maximum private health establishments got registered in 2013. Since then, more than 15,000 facilities are getting registered every year. In 2016, 16,282 facilities registered and 3,30,186 TB patients were notified from private health establishments," the report stated.

India saw the highest number of TB deaths among children in 2015, according to a Lancet study.

The researchers’ case-fatality-based analysis suggested that 239,000 children younger than 15 years died from TB in 2015, with 191,000 deaths occurring in children younger than 5 years (more than 80% of the deaths in children aged less than 15 years). Almost all of these deaths ( more than 96%) occurred in children who were not receiving treatment for TB.

“Most deaths were in the World Health Organisation (WHO) Africa and Southeast Asia regions, both for under-5 and under-15 mortality; the highest individual country mortality was found in India, Nigeria, China, Indonesia, and the Democratic Republic of the Congo. All these countries are on the current WHO list of 30 high TB burden countries; all are populous, with tuberculosis incidence rates under 400 per 100,000 per year," the study said.

The study also highlighted that TB in children is increasingly recognised as an important component of the global tuberculosis burden, with an estimated 1 million cases in 2015.

Although younger children are vulnerable to severe forms of tuberculosis disease, no age-disaggregated estimates of paediatric TB mortality exist, and tuberculosis has never been included in official estimates of under-5 child mortality.

According to WHO statistics for 2011, India is the highest TB burden country with an estimated incidence of 2.2 million cases of TB out of a global incidence of 9.6 million cases.

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