In 2014, a group of medical professionals embarked on a mission to eradicate Tuberculosis from Haryana. From its humble roots as a research project, Mission TB Free Haryana has swiftly grown to become a national level initiative called Mission TB Free India, under the guidance and support of Dr Naresh Trehan, Chairman and Managing Director, Medanta.

Mission TB Free Haryana is a collaborative effort between the Government of Haryana and Medanta, in association with the International Union Against Tuberculosis and Lung Disease (The Union), and the Central TB Division of the Ministry of Health & Family Welfare, Government of India.

Tuberculosis Treatment in India

Every year, India witnesses over 8,50,000 cases of TB that go undiagnosed and untreated.

In 2017, the World Health Organisation (WHO) released a Global TB Report which cited the shortcomings of TB diagnosis and treatment in India. Some of these challenges were:

1. Lack of awareness about Tuberculosis,
2. Financial upheavals faced during the treatment,
3. Lack of commitment towards completion of drug duration,
4. Social barriers like limited access to healthcare and lack of availability of services

In 2015, in an effort to further the plans of eradication of Tuberculosis, the Revised National TB Control Programme (RNTCP), Medanta, along with our team, spearheaded Mission TB Haryana. The objective of this program was to assist existing government structures in increasing diagnostic pickup of TB, to educate people about Tuberculosis and help reduce the disease burden in remote and rural parts of India.

About Mission TB Free Haryana

The goal of Mission TB Free Haryana was to cover all 21 districts across Haryana with the help of mobile medical vans equipped with a digital chest x-ray.

A recent addition to this arsenal has been the GeneXpert machine (a very reliable molecular diagnostic test).

Now, Sputum examination as per the RNTCP diagnostic algorithm is carried out by a large network of government-designated microscopy centres (DMCs) located in the PHCs / CHCs.This was made possible with 4 specially-equipped mobile vans donated by the Oriental Bank of Commerce, Siemens, R J Corp and RITES.

Introduction of CB-NAAT - A Breakthrough Device for Gene Testing

The next phase of Mission TB saw the introduction of the CB-NAAT or Cartridge-based Nucleic Acid Amplification Test machine as per the RNCTP’s diagnostic algorithm. The CB-NAAT is a WHO-endorsed gene testing machine that can swiftly and accurately detect tuberculosis.

Test results over a 4 year period

Expanding Mission TB

1. TB Free Pataudi
   
   

   
   
   “TB Free Block Pataudi” has just started using Active Case Finding methodology. Partnered with and strongly supported by the government, Medanta has hired 10 volunteers to team up with ASHAs the grassroots health workers in the villages and screen a population of 6 lakh people in the Pataudi block. The ones who screen positive for cough are invited to attend camp with x-ray, sputum and geneXpert facilities available at point of care. The diagnosis is confirmed on the same day, Nikshay notification done and the patient started on treatment. The goal is twofold - to eradicate TB from the block over the next two years and to develop a cost-effective model that can be scaled.
   
   For more updates follow: www.facebook.com/TB-Free-Haryana
   
   

2. Strategic Partnerships

   
   
   
   The team has also formed a consortium of companies consisting of GE, KPMG and Social Alpha to develop a skill mix that tackles all aspects of TB care – clinical, technological, financing and monitoring. A continuum of care model has been developed which looks at a holistic approach.
   
   The proposed continuum of care approach involves:
   
   
   1. Awareness and outreach campaigns for screening
   2. Having enough mobile medical vans with updated equipment
   3. Faster screening with artificial intelligence-based X-ray interpretations
   4. Setting treatment regimes and schedules
   5. Conducting Behaviour Change Campaigns for further education and awareness
   6. Assessing treatment effectiveness over time
   7. Introducing digital tools like chatbots and helplines for counselling and assistance

After the successful execution of 2 phases of Mission TB, Haryana, Medanta is now aligning with the Government of India's directive to try to make India TB-free by 2025. Our project has evolved into an exemplary TB control model that can be scaled up to other states.

Phase 1 of this expansion will focus on a few high-impact states like Jharkhand, Madhya Pradesh, Uttar Pradesh, and Meghalaya starting from 2020. The idea is to reach out to the remotest corners of India and eradicate TB from its roots.

Thanks to the help of our skilled medical personnel, effective usage of existing technologies and medications, innovations for sustenance, and optimal funds from corporates, we are truly on our way to make ‘Mission TB Free India’ a reality.