India to involve faith leaders in TB programme

Aarti Dhar, CNS Correspondent, India
(First published in
Inspired by the role of faith-based leaders in eliminating polio, the Indian government is now all set to involve religious institutions in reaching out to people for TB services. Beginning this month, the International Union Against Tuberculosis and Lung Diseases (The Union) will start training the trainers from the Muslim community who, along with volunteers, will help in identifying cases and disseminating information about the disease.

A similar exercise will be initiated with churches, gurudwaras and Hindu religious organizations in reaching out to the communities for TB services, according to Dr Subrat Mohanty, Coordinator, Project Axshya (which means ‘free of TB’) of The Union. Project Axshya is an innovative civil society initiative aimed to improve access to TB diagnosis and treatment in India and is implemented by The Union’s South East Asia office under grant from The Global Fund.  The Project is being implemented in 285 districts across 19 states, covering a vast population of 250 million poor and backward, 50 million tribals and 40 million in urban slums. "Religious leaders have a wider reach and network, are respected and accepted by a specific community," Subrat said. The Union approached the Madrasas in 15 districts of Bihar with TB information, including identifying symptoms and accessing treatment and diagnostic services. It has so far reached out to 17,000 students and teachers of Madrasas with TB information, and collected sputum samples which were sent for pathology tests and the patients referred to the nearest treatment centre.

The entire exercise began with a workshop with Muslim religious leaders on December 22, 2015 which was followed by a state level meeting organized by the Central Wakf Board in March 2016 where heads of 38 district wakf committees attended. Another state level workshop was organized in July 2016 where information on TB was disseminated. The leaders now endorse the national TB control programme in several ways by sharing information after Friday prayers, giving out education material to the community, and conducting information sessions at mosques. So far, Project Axshya has worked in Madrasas in 6 districts of UP and 9 districts of Bihar. TB is preventable and curable in the vast majority of cases, and yet it remains one of the world’s most pressing public health challenges, killing more people worldwide than any other infection. In 2015, there were 10.4 million new TB cases worldwide and 1.8 million people died of it. In addition, multi drug-resistant TB (MDR-TB) is adding to the epidemic. According to the figures in the WHO’s annual Global TB Report 2016, there were an estimated 580,000 cases of MDR-TB and 1.8 million deaths from TB including 400,000 deaths among people with TB-HIV co-infection.

TB remained one of the highest ranked causes of death worldwide in 2015 and was the single most deadly infectious disease. 6 countries alone account for 60% of new TB cases, which include India, Indonesia, China, Nigeria, Pakistan and South Africa. One of the targets of the Sustainable Development Goals (SDGs) is to end the global TB epidemic by 2030. The WHO’s "End TB Strategy", approved by the World Health Assembly in 2014, calls for a 90% reduction in TB deaths and an 80% reduction in TB incidence by 2030, compared with 2015. However, in order to meet this deadline, progress in fighting the disease needs to be accelerated and new approaches developed. The role of faith and communities has been valued in the fight against HIV and is now being looked to as a means to challenge TB.

Through Project Axshya, there are 25,000 rural healthcare providers, serving as first point of contact for healthcare in rural populations. They have been trained in TB diagnosis and treatment and linked to India’s National TB Control Programme. Close to 10,000 villages have been declared “Axshya villages” by the people who live in the villages themselves and as many as 84,000 people have learned their rights and responsibilities as TB patients through an illustrated patient charter published in 19 regional languages. Nearly 655,981 sputum samples were collected and transported for testing by community volunteers, resulting in diagnosis of about 55,293 TB patients who were initiated on treatment.

Aarti Dhar, Citizen News Service - CNS
March 7, 2017