A parliamentary panel has cautioned the Union health ministry against “complacency” over its initiative that urges non-government entities to provide nutrition and other support to patients, saying the scheme cannot be the mainstay in efforts to control TB.
The Nikshay Mitra initiative has “demonstrated the power of collective action” to address challenges posed by the disease, but this adoption model “cannot be considered as the mainstay to fight against TB”, the parliamentary standing committee on health has said.
Nearly 80,000 individuals, non-government and corporate entities have adopted over 950,000 TB patients across the country by March 2023 under the Nikshay Mitra initiative. In August this year, the Indian Air Force pledged support to 765 TB patients.
The parliamentary panel, however, has expressed its “concerns” over what it described as a “sense of complacency within the ministry and the government organisation responsible for the TB elimination programme due to shift in their responsibility to non-government organisations which eventually may impede the overall progress”.
The panel, reviewing India’s efforts towards its goal to eliminate TB by 2025, has asked the government to establish “a robust selection process” for Nikshay Mitras and implement a monitoring mechanism to ensure their digilent fulfilment of responsibilities.
A doctor familiar with the TB control programme said the parliamentary panel’s observations about the “shift in responsibility” appeared to echo concerns shared by some public health experts.
“The invitation to individuals and to non-government organisations to provide nutrition to TB patients is absolutely an example of task shifting by the government,” a physician who requested anonymity told The Telegraph.
“Without doubt, the Nikshay Mitra has many plus points, it will help reduce the stigma against TB, it can help in the integration of TB patients if, for example, organisations provide vocational support to TB patients. “But nutritional support should ideally come from the government,” the doctor said.
The parliamentary panel has also asked the Centre to take steps to provide nutritional support on a large scale to undernourished people who are at relatively high risk of developing active TB.
“The government must diversify the diet provided under various social protection schemes like the food security scheme and the mid-day meal scheme to ensure adequate calorie, protein and micronutrient requirements are fulfilled in the meals,” the panel observed.
The panel has called for an integrated programme that uses the public distribution systems to tackle malnutrition and reduce the risk of developing TB.
“Post-treatment follow-up of patients, including their nutritional status, should (also) be ensured after completion of treatment,” it said.
A landmark Indian study by government and private doctors earlier this year had shown that a food basket containing 5kg rice and 1.5kg lentils per adult per month can cut by nearly half new TB cases among household contacts of TB patients.