"We need to bring down the annual TB incidence rates have to reduce by 20% annually from the current 2%, if we have to achieve our goal of TB-free India. To achieve this active case finding is very important by reaching out to the community, especially in high-risk areas. We need a two-way trust between government and NGOs. Flexibility in programmes is necessary. There must be coordination between different NGOs and between NGOs and government. We also require strict regulations for the private sector. We cannot work in silos," he said.
Kavita Ayyagari, Project Director Challenge TB project, stressed upon corporations to direct some of their corporate social responsibility (CSR) activities towards achieving the goal and also to have work place interventions for care and control of TB. Even within the government a lot of interdepartmental action is needed.
Dr Rueben Swamickan, TB Advisor, USAID, called the patient to be the 'VIP' of the programme. He insisted that, "talks must translate into action. We have to bring diverse skills together for patients' benefit. All private and public service providers need to be competent enough to provide proper diagnosis and treatment. Patient should be able to get high quality care wherever he/she goes".
In fact, the public and private delivery systems should not compete but work together with the delivery recipient (patient) and perhaps a decentralized patient centric care system might work better.
'Islands of excellence in a sea of mediocrity?'
Stigma is another big problem that makes us sweep TB under the carpet. It often deters TB patients from either seeking treatment and/or completing it. Dr PC Bhatnagar from Voluntary Health Association of India (VHAI) felt that action is not percolating to the district/sub district level. According to him, "We cannot have islands of excellence in a sea of mediocrity."
Activists Loon Gangte and Hari Singh of Delhi Network of People living with HIV (DNP+) rightly pointed out that there is much less information, education and awareness in TB patients as compared to people living with HIV (PLHIV). There are very few TB activists from the patients. PLHIV networks can help in this direction, as TB is a very high-risk mortality factor for them.
One important step in the direction of making a TB-free India a reality is to empower the TB patients. In them lies the solution of the problem.
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