Tuberculosis in India: A Stakeholders Analysis
Tuberculosis is a highly contagious disease, and the world is currently facing difficulties dealing with tuberculosis, especially in the time of the parallel COVID-19 pandemic. Most of the attention is drawn to COVID-19 nowadays, and such a problem as tuberculosis is often omitted. However, the populational statistics show worrying results regarding the incidence and prevalence of TB in the world. “Ahead of the first 2020 milestone, tuberculosis still accounts for the highest mortality from any infectious diseases worldwide, even surpassing HIV/AIDs, causing 1.5 million deaths in 2018” (Harding, 2020, p.1).
India is the country with the highest burden of tuberculosis in the world, with the annual number of new cases reaching almost 3 million (USAID, 2019). The government of India and international foundations are working diligently to decrease the incidence of tuberculosis and provide patients with appropriate treatment. Additionally, the COVID-19 pandemic complicates the situation with tuberculosis due to financial and medical aspects. There are several stakeholders that can be identified as well as their effect on the current situation with tuberculosis in India. The analysis of their impact on tuberculosis may help improve the preexisting strategies for fighting tuberculosis and develop new ones.
|Involvement in the issue||Interest in the issue||Influence/Power||Position||Impact of the issue on actor|
|Multidrug-resistant tuberculosis(MDR-TB) patients||MDR-TB patients usually have complicated treatment plans, low adherence to therapy. Due to COVID-19, some are unwilling to visit doctors but can still spread TB through household contacts. May develop extensively drug-resistant (XDR) TB (Shrinivasan et al., 2020).||Medium||Medium||Depends on a particular patient||Medium|
|Population with weakened immunity||Fewer children are getting BCG vaccine, chances of developing both latent and active TB increase (Shrinivasan et al., 2020). The HIV pandemic makes patients more susceptible to TB infection.||High||Medium||Depends on a particular patient||High|
|Ministry of Economics||Economic recession leads to decreased funding of TB programs in general. COVID-19-related issues divert part of the funding from TB to COVID hospitals and laboratories (Pai, 2020).||Medium||High||Unsupportive||Medium|
|United States Agency for International Development (USAID)||Developing programs to fight the TB pandemic. Providing financial support. Supplementing with novel drugs for the treatment of MDR-TB and XDR-TB (USAID, 2019)||High||High||Supportive||High|
|TB-designated hospitals||Diverting healthcare workers from TB to COVID departments. Utilization of TB diagnostic laboratories for COVID. Conversion of hospitals to care for COVID patients (Behera, 2021).||High||Medium||Unsupportive||High|
Tuberculosis is a severe problem affecting the world population and especially the people in India. The current epidemiologic situation, which includes COVID and HIV pandemics, substantially complicates the fight against tuberculosis. It forces health institutions to adapt and develop new strategies. During the analysis, several stakeholders were identified: MDR-TB patients, populations with weakened immunity, TB-designated hospitals, and such governmental institutions as the Ministry of Economics and the United States Agency for International Development. Governmental institutions are mainly responsible for the financial matter of the pandemic; also, USAID is providing hospitals with drugs.
Ministry of Economics is compelled to divert finances to fight COVID, decreasing TB programs’ funding, which negatively impacts the tuberculosis pandemic. MDR-TB patients and populations with weakened immunity may positively and negatively affect the tuberculosis situation depending on the person’s responsibility and compliance to treatment regimens. TB-designated hospitals are forced to convert into COVID departments to take care of COVID patients now, although it is essential to find a compromise in the future.
Behera D. (2021). TB control in India in the COVID era. The Indian Journal of Tuberculosis, 68(1), 128–133. Web.
Harding E. (2020). WHO global progress report on tuberculosis elimination. The Lancet. Respiratory medicine, 8(1), 19. Web.
Pai, M. (2020). Tuberculosis and Covid-19: Fighting a deadly syndemic. Forbes. Web.
Shrinivasan, R., Rane, S., & Pai, M. (2020). India’s syndemic of tuberculosis and COVID-19. BMJ Global Health, 5(11), e003979. Web.
USAID. (2019). Tuberculosis in India. Web.