2019 S1 HSYP801: Tuberculosis in India - Public Health Report

This report provides an overview of the tuberculosis situation in India, highlighting the country's significant disease burden. It details the interventions implemented by the Indian government, including the use of clinical algorithms for screening, the provision of free drugs and diagnostic tests, and community development initiatives. The report emphasizes the importance of ethical considerations, particularly the application of Kass's ethical framework to assess the interventions' impact on privacy, justice, and self-determination. The analysis includes pre- and post-intervention evaluations to determine effectiveness in maintaining ethical principles. The report concludes that effective interventions are crucial to address the public health issue and improve survival rates in India, referencing key studies and the national strategic plan.

Running head: TUBERCULOSIS IN INDIA
TUBERCULOSIS IN INDIA
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1TUBERCULOSIS IN INDIA
India holds for the 1/4th of the global tuberculosis burden and accounts huge burden for
the infection as well the MDR TB. In 2016, there has been more than 29.7 lakh case of
tuberculosis in India out of which 5.2 lakh people died due to it. The major reason behind such
large occurrence of disease is lack of proper knowledge of tuberculosis and the health service.
Globally, India hold more than 28.7% of total cases of tuberculosis (1). The country contribute to
more than 24.9 % death worldwide. Therefore, there is the great need to develop relevant
intervention to prevent the disease in the growing population of India. The major aim of the
essay is to highlight the various intervention that is taken by the government of India to solve the
issue of tuberculosis outbreak. Government of India has developed national strategic plan 2012-
2017 to implement five year plan to combat tuberculosis (2). The major intervention taken to
prevent the incidence of disease are as follows:
1. Government has emphasised on the usage of clinical algorithm for screening of the
infection which depend on the presence and absence of the symptoms such as cough, loss
of weight, night sweat and fever. It is done to identify the people who have symptoms
and can be taken further for diagnostic work up. CBNNAT test will be provided to such
people for early diagnosis of the disease so that it can be treated and does not cause high
mortality rate (3).
2. Government of India are providing free tuberculosis drug to the affected population in
addition with free diagnosis and test of the disease.
3. Government has establish community development in the rural sector to give education
about the infection, maintaining health hygiene and ways to manage and eradicate the
prevalence of the disease. The collaborative framework is also linked with preventing the
use of tobacco and consumption of alcohol (4).

2TUBERCULOSIS IN INDIA
Ethical framework for public health by Kass provide tool that involve six step by step
ethical analysis of each of the intervention. By using the framework, the risk related to the
privacy, justice and confidentiality is assessed by knowing the potential burden of the
intervention. The framework evaluate how the interventions are fairly implemented which refers
to the ethical principle and justice to the peoples (5). The intervention of applying algorithm of
clinical screening of the infection, making free tuberculosis drug available and community
development can be ethically analyzed as the framework involve positive obligations and
distinguish three groups of ethical burden ie risk to privacy, justice and self-determination. Each
of the intervention is checked for its goal, its effectiveness, potential burden, ways to minimize
the ethical issues, justice to peoples and balanced of benefit and burden. Step 3, 5 and 6
determines the effectiveness of the intervention in maintaining ethical principles. The analysis is
done pre and post application of the intervention (6).
Lastly, it can be concluded that, tuberculosis in India needs effective intervention that can
solve the public health issue and increase the survival rate of people in India.

3TUBERCULOSIS IN INDIA
Reference
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White RG, Salomon JA, Cohen T, Foster N. Catastrophic costs potentially averted by
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