Health Kalon’s Message on World TB Day – 24 March 2016

March 24 commemorates the day in 1882 when Dr. Robert Koch discovered the cause of Tuberculosis (TB), the tuberculosis bacillus. Since then, 24th March is observed every year as World TB Day worldwide. This year’s “World TB Day” theme is aptly titled “UNITE TO END TB”. World TB་day is an opportunity to raise awareness about the enormous burden of TB. With 1.5 million TB-associated deaths per year, TB is a top infectious killer worldwide. TB, HIV-associated TB & MDR-TB represent a threat to development and global health security. For World TB Day, 24 March 2016, WHO calls on governments, communities, civil society, and the private sector to “Unite to End TB”WHO and partners are promoting dialogue and collaboration that unites individuals and communities in new ways to end the tuberculosis (TB) epidemic. Four subthemes under the Unite to End TB theme that WHO is promoting are; Together we can prevent TB by ending poverty, Together we can better test, treat, and cure, Together we can end stigma and discrimination, Together we can drive research and innovation

TB is a top killer worldwide ranking alongside HIV/AIDS. Globally, in 2014, 9.6 million fell ill, 1.5 million men, women and children died, 1.2 million PLHIV developed TB. Of the 9.6 million new TB cases in 2014, 58 % were in the South -East Asia and Western Pacific regions. The African Region had 28 % of the world’s cases in 2014.A recent WHO report has ranked India with having the highest number of TB cases in the world. As per the WHO Global TB Report 2015, in 2014 2.2 million cases were estimated in India which is higher than in any other country.

According to data available at Department of Health, CTA, from 7 hospitals, 1168 cases of TB were reported between 2012-2014,out of which 759 (64.98) were male and 409 (35.02% ) were female. TB cases were highest in the age group of 15-24 (46.96 %), followed by age group of 25-34 (21.17%). In terms of occupation, TB case s were highest in students (38.1 %) and monks (21.23%). The percentage of MDR TB cases among new TB cases is 3.63 % while among previously treated TB cases it is 22.79 %

Tuberculosis (TB) is caused by (Mycobacterium Tuberculosis) that most often affect the lungs. Tuberculosis is curable and preventable by prompt and proper diagnosis and treatment. TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected. About one-third of the world’s population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit the disease. People infected with TB bacteria have a 10% lifetime risk of falling ill with TB. However, persons with compromised immune systems such as people living with HIV, malnutrition or diabetes, or people who use tobacco have a much higher risk of falling ill. When a person develops active TB disease, the symptoms (cough, fever, night sweats, weight loss, etc.) may be mild for many months. This can lead to delays in seeking care, and results in transmission of the bacteria to others.

The Department of Health, Central Tibetan Administration has been striving hard to prevent and control tuberculosis in the community ever since launching of its TB control program. As recommended by WHO, the TB control program of the Department is following the DOTS guideline. Besides installing basic TB diagnostic facilities such as Xray machine & medical laboratory facility in some of the major hospitals and health centres computerized radiography (CR) systems are being installed at Tso Jhe hospital in Bylakuppe, DTR hospital in Mundgod, DVT hospital in Kollegal & Tibetan Primary Health Centre in Dekyiling to ensure proper TB diagnosis. Department is planning to install new Xray machine at Phende Hospital in Hunsur, Tibetan Primary Health Centres iat Mainpat & Miao in the near future. Furthermore, to ensure that drug resistant tuberculosis are diagnosed at the earliest and treated effectively, Gene X-pert CBNAAT system are being installed at Tso Jhe Hospital in Bylakuppe, DTR hospital in Mundgod &Tibetan Primary Health Centre in Dekyiling. Active TB awareness campaign & case finding is pursued in the congregate settings such as schools and monasteries and amongst general public to prevent and control transmission of tuberculosis. TB drugs are provided either free of cost to the patients or subsidized in hospitals and health centres under the Department, while in Indian govt. TB facility it is free.

While organizing a variety of campaign related activities to raise awareness about the epidemic disease among common public I request the school students, the health workers and the general public to participate in the National level online quiz competition on Tuberculosis on 24th March 2016 in connection to World TB Day. TB Free India Online Campaign is a national level movement initiated by various voluntary organizations for supporting the Tuberculosis Control programme. For guidelines and instructions you may log on to – www.tbfreeindia.com.

In conclusion, Despite significant improvement in TB situation in the community, TB still continues to remain one of the major health concern in the Tibetan community. I, therefore, call upon everyone to re-dedicate ourselves- the administration, health staff, NGOs & civil societies, and the ordinary people – to work towards elimination of TB from our society and make Tibetan community a TB Free community.

Dr Tsering Wangchuk