Parliamentary Panel asks govt to use technologies like drone to eradicate TB

A Parliamentary Panel that looked into the implementation of Pradhan Mantri TB Mukt Bharat Abhiyan (PMTBMBA) has advised the Centre to use latest technologies such as drones, data integration systems and mobile apps to strengthen surveillance in order to test, control and eradicate tuberculosis from the country.

It also recommended a special emphasis on PMTBMBA under Ayushman Bharat PMJAY through dedicated deployment of staff and allocation of budget for PMTBMBA under Ayushman Bharat. Ni-kshay portal may also be integrated with Ayushman Bharat Digital Mission.

The Department-Related Parliamentary Standing Committee on Health and Family Welfare, in its 149th report on implementation of Pradhan Mantri TB Mukt Bharat Abhiyan, said, “As the Ni-kshay portal has the potential for continuous surveillance and monitoring of each TB patient from detection to completion of treatment, it can be used to contact and track TB patients for early detection and treatment follow-up. In view thereof, the Committee suggests making the Ni-kshay portal more user-friendly and a one-stop platform for TB data collection.”

“Other technological interventions like mobile applications for continuous monitoring of TB patients, district-wise vulnerability mapping, and active case finding may also be developed by leveraging digital tools to strengthen the surveillance of TB cases,” it added.

The Committee believes that the Government may envisage comprehensive utilisation of new technologies like drones to aid the transportation of samples and drugs between the primary health centres and district hospitals in rugged and hilly terrains. The recommendation is on the backdrop of a model developed in Himachal Pradesh.

Timely transportation of sputum samples and TB drugs is a challenge in the mountainous terrain of Himachal Pradesh. In the Mandi district, a Memorandum of Understanding was executed with a private service provider company for the use of a Drone for the transportation of sputum sample and TB drugs between the district centre at Mandi and the block headquarter at Janjehli. The usage of drones reduced both transportation time and operational costs to one-fourth, it observed.

The Committee further suggested that the concept of FAST (Find, Assess, Support and Treat) centres as a single window system, as undertaken in Tamil Nadu, may be implemented across the country. The private clinics/nursing homes without diagnostic capacity may be linked to the nearest FAST centre, it said.

In the state of Tamil Nadu, the FAST centre is being organised as a single window system for notification of patients diagnosed with TB, linkage for public health actions and treatment adherence support to ensure standards of TB care as well as enhance the participation of all private hospitals and professional organisations in TB control activities. It is seen that notifications from FAST centres have increased by 47% as compared to an increase of 19% in non-FAST centres during the period from 2019 to 2022.

The Committee also recommends that all clinical data on the Ni-kshay portal be recorded in standard form and connected through telemedicine so that each patient can be viewed and managed by any health service provider in the country. Further, it proposed regular use of telemedicine and meeting apps like Zoom or Google Meet for real-time monitoring and follow-up of patients after treatment.

Surveillance of TB can be strengthened in line with the successful programmes for Polio and Smallpox eradication implemented in the country.

As part of endeavours to improve detection, integrating an active case-finding drive for TB with the existing house-to-house survey conducted by ASHA workers twice a year for the immunisation programme can be considered. Conducting household visits is essential to achieve a complete detection of TB cases. All individuals suspected of having TB, whether symptomatic or asymptomatic, should be brought to clinics or diagnostic laboratories for testing, ensuring thorough screening for TB positivity, particularly in high- risk areas like slum areas and densely populated areas.

“The Committee believes that addressing malnutrition should be of immense importance to win the battle against TB. Therefore, the Committee suggests that food and nutrition- related programmes should be strengthened and integrated with the PMTBMBA programme through the public distribution system and another system, as medicines alone might be insufficient without proper nutrition, and both must be integrated,” it added.

Going forward, it suggested that the 5,000-6,000 public representatives across the country collaborate with officers and NGOs, each representative could support around a hundred cases, which is feasible. Public representatives like MPs and MLAs can be encouraged to utilise their grants or funds for PMTBMBA in their constituency or state to provide medicines and nutritious food.

“Further, the Committee believes that another area requiring the attention of the Government is efficient resource management and its effective channelisation, which can motivate representatives at all levels to assist TB patients,” it added.

The effective engagement of State Governments is critical for successfully implementing centrally sponsored programmes. The Committee believes that State Governments should pull up their socks to participate in PMTBMBA on mission mode to achieve the target of ending TB by 2025.

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