Lending a helping hand as Ni-kshay Mitra to eliminate TB

Vinod K Paul
In 2018, the Prime Minister set an ambitious target of eliminating TB in the country by 2025, five years ahead of the global timeline. This spurred all-round acceleration in India’s efforts to prevent, detect and treat TB. The Government is providing free TB diagnosis, newer drugs and treatment modalities along with patient support including financial and nutritional benefits.    
Public health experience has showed us that undernutrition and TB form a vicious cycle. Poor nutritional status predisposes an individual to get infected by the disease, or have a dormant disease manifest clinically. And, TB, a serious systemic disease, leads to depletion of nutrient reserves and aggravation of undernutrition. Optimum nutritional support to TB patients improves weight gain, adherence to therapy, muscle strength, quality of life, robust recovery and reduced mortality. Good nutrition also prevents relapse of the disease. With a sharper focus on the nutritional improvement among TB patients, Union Health Ministry launched the Nikshay Poshan Yojana in 2018 as part of National TB Elimination Programme (NTEP) which provides direct cash benefit transfer of INR 500 per month to TB patients on treatment. Since 2018, over Rs 1830 Cr have been disbursed to about 70 lakh beneficiaries under this initiative.
It is a well-established public health dictum that community participation and support provide a decisive edge to health programmes. Large-scale country-wide health programmes such as smallpox and polio eradication, ongoing Universal Immunization Programme, Poshan Abhiyan, Swachh Bharat Abhiyan and the recent COVID-19 management action became a success only through Jan Bhagidari (people’s participation). Community participation plays a key role in mass awareness, behaviour change, demand creation, clearing myths and in convincing the reluctant to embrace services. The success of these health programmes reinforced our belief that a further augmentation of multi-sectoral approach involving community and institutional- stakeholder support in TB elimination is required. This can play a pivotal role in addressing the social and nutritional determinants, thereby contributing toward the attainment of national goal.
Jan Bhagidari forms the core principle of the recently launched Pradhan Mantri TB Mukt Bharat Abhiyaan to provide additional support to TB patients. Under this country wide Abhiyan, Ni-kshay Mitras can adopt and care for TB patients. Ni-kshay Mitras are volunteers and they could be individuals, NGOs, co-operative societies, corporates, elected representatives, institutions (private and public) and even political parties. They commit to help the TB patients through nutritional support, nutritional supplements, additional investiga- tions and vocational support. The support is provided only after consent from the patients, and a Ni-kshay Mitra can engage for a duration ranging from six months to three years. The support is delivered on your behalf by the district TB program teams in a transparent way. None of the other care and medical services being provided by the Government gets affected by this voluntary community initiative. It is simple to become a Mitra by accessing a user-friendly digital platform designed for suppor- ting persons with TB at Ni-kshay 2.0 portal; http://communitysupport. nikshay.in.
Compassion, empathy and concern for the TB affected citizen is at the heart of the scheme. The model of Ni-kshay Mitra is unique in the history of TB elimination in India as on one hand it has ushered in a ray of hope to the TB patients, and on the other hand fosters community connect with the program. This public health initiative has already shown brilliant uptake. It is heart-warming that within three months of its launch, more than 52,000 Ni-kshay Mitras have registered. Over 13.36 lakh patients are on TB treatment and approximately. 10 lakh people have consented to be connected to Ni-kshay Mitras. It has steered more confidence in us for providing the continuum of health services for the TB patients.
The Pradhan Mantri TB Mukt Bharat Abhiyan should be seen as a people’s movement within a much larger public health and medical endeavour to make TB history. Active case detection and diagnosis, anti- TB treatment (including that for drug-resistant forms), public-private participation and IT enabled program implementation etc. – all the tools are being fully mobilized. Tribal districts and hard-to-reach populations are getting special attention. We have to break the chains of TB transmission in every hamlet, every village and every city. No TB patient can be left behind. I and my family members have adopted seven TB patients in Himachal Pradesh.
It is also our duty to de-stigmatise TB disease. It is not the fault of the individual that s/he got the disease. Evidently, there is still a huge potential to increase Jan bhagidari for the noble cause eliminating TB from the face of our beloved nation. I urge the readers to join the swelling brigade of thousands of Ni-kshay Mitras. Helping a TB patient could avert ruinous downslide of a family due to wage loss. Your humanitarian support could save the life of a TB patient who is mother, father, brother, sister or a spouse of a fellow citizen.  
Mahatma Gandhi said, “To give pleasure to a single heart by a single act is better than thousand heads bowing in prayer.”
TB Harega, Desh Jeetega! Dr. Vinod K Paul is Member (Health) NITI Aayog and a Nikshay-Mitra. Views are personal.