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Championing a TB-Free India

USAID partners with Government of India and key stakeholders to achieve a TB-free India.

Since 1998, USAID has partnered with the Government of India (GOI) to combat tuberculosis (TB), investing more than $120 million to help diagnose and treat 15 million people with the disease. 

India has the largest number of tuberculosis (TB) cases in the world — more than a quarter of the global TB and multidrug resistant TB burden.  The World Health Organization estimates that 2.8 million people in India are infected with TB annually, and more than 420,000 people die from it.  USAID supports a national movement to make India TB-free by leveraging local intellectual, financial, and technical resources in order to accelerate the national TB program and increase cross sectoral support for combatting the disease. 

USAID/INDIA PROGRAMS

USAID partners with technical experts, the Revised National TB Control Program (RNTCP), the private sector, civil society, communities, and patients to achieve a TB-free India.  USAID supports a host of activities under the Call to Action for a TB-free India, including integrated care and prevention, raising awareness through public advocacy, and investments in research. 

Integrated Care and Prevention 

Targeting the urban poor: Urban environments tend to have a greater concentration of TB, as well as higher levels of transmission.  USAID is working in mega-million cities to ensure that urban patients — particularly slum dwellers and other low-income populations — are diagnosed on their first visit to a health care facility.  The TB Health Action Learning Initiative (THALI) project trains health care professionals to follow the standards for TB care and to implement successful innovative approaches to diagnose and treat TB and drug-resistant (DR-TB). 

Addressing Drug Resistant (DR) TB:  India has the highest number of DR-TB in the world, about a quarter of the world’s DR-TB.  Treatment of DR-TB cases requires substantial time and resources.  USAID helps address this growing epidemic by: (1) Supporting a national unit that helps the GOI to address issues related to DR-TB with newer diagnostics and shorter treatment regimens; (2) Funding the first anti-TB drug resistance survey in India; and (3) Contributing to Global Health Security Agenda (GHSA) efforts by supporting the GOI in addressing antimicrobial resistance.

Expanding Access and Quality:  Nearly three quarters of patients initially seek care through the private sector, yet private care providers may not be aware of the latest research on newer diagnostics or guidelines for treatment.  To improve treatment outcomes, USAID engages with private care providers to raise awareness and adoption of the evidence-based National TB Standards for Care.  USAID also supports an assessment of India’s TB diagnostic capabilities.

Raising awareness through public advocacy

USAID supports the Call to Action for a TB-free India to engage health care providers, corporate partners, media, celebrities, parliamentarians, civil society, academia, and patients.  This campaign raises awareness about the disease, works to reduce social stigma, empowers communities to take an active role in the effort, and encourages health care professionals to implement best practices to reach, cure and prevent TB.  USAID also supports a state-level campaign that will take the momentum generated from the Call to Action for a TB-free India to advocate and provide outreach in select states. 

Cutting-edge Research And innovation

USAID partners with the private sector, non-governmental organizations (NGOs), and other donors to solicit ideas from local innovators to improve treatment adherence and TB diagnostics in order to apply these proven practices to other high-burden countries.  Selected innovators are paired with mentors and like-minded individuals to develop and pursue health care solutions to take successful pilots to market.  One example of this is the “99 DOTS” program, which enables treatment adherence.  After successful implementation in 30 public healthcare facilities, the program is now being scaled nationally in partnership with the Government of India.

Additionally, USAID has partnered with the GOI to roll out a rapid diagnostic test for TB and DR-TB, the Cepheid Xpert® MTB/RIF assay (GeneXpert®). GeneXpert® is a revolutionary diagnostic tool that can rapidly and accurately detect TB resistance to rifampicin, one of the most potent drugs used in the treatment of TB.  Greater access to this test boosts healthcare workers' ability to diagnose TB quickly, thus reducing TB transmission and premature TB deaths.  Currently, GeneXpert can be found in 628 health facilities across each district in India, and the GOI plans to purchase over 800 additional machines.

At a Glance: TB in India*

  • 2.8 million new TB cases per year
  • 420,000 deaths from TB per year
  • 147,000 multidrug-resistant TB (MDR) cases per year
  • 87,000 TB-HIV cases per year

*Estimates from WHO Global TB Report, 2017

Last updated: July 11, 2018

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