TB Champions- An important initiative in the direction of TB elimination from India

Tuberculosis (TB) is an age-old disease caused by Mycobacterium tuberculosis.^[1] This bacteria could be prophesied as a conditional pathogen as it causes TB only in immunocompromised individuals. ^[2] Around 90% of individuals infected with M. tuberculosis can control the infection spontaneously.^[3] The disease is a major cause of morbidity and mortality in the underprivileged countries of Asia, Africa, and Europe.^[1] India is a high-burden country and is battling both the drug-sensitive and drug-resistant forms of Mycobacterium tuberculosis.^[4] The disease is a great contributor to the loss of disability-adjusted life years (DALYs) among other infectious diseases. ^[5] The extent of this public health obstacle is evident by a very high incidence and prevalence i.e., 188 and 312 per one lakh population.^[6] Indian Government under the leadership of the current prime minister aims to eliminate TB from India by 2025 ^[6]. This is five years earlier than the international goals.

The National Strategic Plan (NSP) for 2017–25 for TB elimination in India proposed some very novel changes to the way this infectious disease is looked at. ^[7] The most important of these transformational changes include the inclusion of ‘TB champions’.^[8] TB champions are those survivors of TB who are trained and committed to working for TB elimination.^[9] These TB champions could become crucial in the long-term by supporting people with TB, sensitizing communities, dealing with stigma, advocacy, and community monitoring. ^[8]

The NSP emphasizes a community-based and patient-centered way toward TB in order to reach the unreached and support TB patients.^[9] This is expected to be achieved by the creation of the National TB Forum, State TB Forums, and District TB Forums with TB survivors and Champions, important decision makers, and programme managers as members.^[8] Along with this, the programme will facilitate the creation of community-led TB forums for people affected by TB at the sub-district and village levels. ^[8]

Trained TB Champions could be an important link between TB patients and the National Tuberculosis Elimination Programme (NTEP). They could very well be a solution to the stigma associated with the disease.^[8] TB Champions could also become the voice of the patients suffering from TB.^[8] These TB Champions could help in bringing new changes in the policies which could be more patient friendly. Various schemes like Nikshay Poshan Yojna, Ni-shay Mitras, etc. could be widely circulated with the help of TB Champions. ^[10], ^[11], ^[12]

The program aims of having at least two TB Champions per village in India to address the TB problem.^[8] Around 1.3 million TB Champions will be selected for an average 2000 population per village. ^[8] And to achieve this goal of TB Call to Action Project supported by USAID and REACH has organized 12 capacity-building workshops and trained over 300 TB Champions in the last two years. ^[8] These TB Champions were TB survivors who were selected through an open call for application, followed by personal interviews.^[8] The Central TB Division partnered in organizing these workshops in the respective State TB Cells of Assam, Bihar, Jharkhand, Uttar Pradesh, Odisha, and Chhattisgarh.^[8] The objective of these workshops was to find and employ a set of TB survivors who would work as TB Champions for the success of NTEP. ^[8] The workshops were structured with an emphasis on participatory learning and a focus on two aspects i.e., knowledge-building and skills-building. ^[8]

To conclude, TB Champions are an important addition to the NTEP. These TB Champions could help in the effective dissemination of the various government policies and initiatives toward TB patients. These TB Champions have the experience and training to become the voice of the TB patients ultimately engaging the communities. They were once suffering from TB and this personal experience could be a boon in counseling the current TB patients and suggesting them the right path to overcome the issues. These are also an integral part of society and therefore would be extremely important in working towards the spread of knowledge and also in reducing the stigma associated with the disease. Their experience of TB would help them in identifying the prospective patients and ultimately this would help in early identification, treatment initiation, and triumphant treatment completion. Overall, the successful inclusion of HIV/AIDS survivors towards AIDS control has led to the inclusion of these TB survivors as TB Champions. Further, the novel inclusion of TB Champions is an essential step towards the ambitious aim of TB elimination from India by 2025.

Acknowledgments

None.

Conflicts of Interest

None declared.