World TB Day
Understanding the TB Challenge:
– TB remains a significant public health challenge globally and in India, despite ambitious elimination goals.
– Access to quality TB care, including diagnosis and treatment, remains inadequate for many individuals.
The Need for a Paradigm Shift:
– There is a pressing need for a paradigm shift towards a person-centred approach to TB care.
– Prioritizing the needs and interests of patients and communities is crucial within the healthcare system.
Recognizing Lived Experiences:
– Understanding the lived experiences of those affected by TB is essential for effective care.
– TB should be viewed not just as a medical issue but also as a social, economic, and environmental challenge.
Progress and Challenges:
– Strong TB survivor advocates have emerged, leading to changes in policy and focus areas such as nutritional support and addressing stigma.
– However, there is still a gap between policy intent and on-the-ground realities, particularly in expanding access to diagnosis and treatment.
Making Care More Humane:
– Efforts are needed to make TB care more humane, including mental health support and gender-responsive care.
– Strengthening community-based care models and empowering frontline healthcare workers is crucial.
Addressing Socio-Economic Determinants:
– TB disproportionately affects marginalized groups and is both a health and economic crisis.
– Addressing socio-economic determinants such as poverty, nutrition, and housing quality is vital for TB control.
Leveraging Technology and Innovation:
– Technology and innovation, such as AI and digital health solutions, offer promise in enhancing TB care efforts.
– Investing in better vaccines and leveraging technology can revolutionize TB diagnosis and treatment.
The Path to Elimination:
– Achieving TB elimination in India requires prioritizing person-centred care, addressing social determinants, and embracing innovation.
– By adopting a holistic approach, India can overcome barriers to TB control and create a healthier future for its citizens.
TB: A Lingering Public Health Challenge:
– TB remains a significant global public health concern, with thousands of lives lost daily and India accounting for a substantial portion of global cases.
– Despite advancements in diagnosis and treatment, TB persists as a detectable and curable disease, necessitating a renewed approach to combat it.
World TB Day: A Reminder of Ongoing Battles:
– World TB Day, observed on March 24, commemorates the discovery of Mycobacterium tuberculosis by Dr. Robert Koch.
– Despite medical advancements, the fight against TB, including drug-resistant strains, continues.Challenges
Faced by India:
– India remains a hotspot for TB, despite ongoing efforts through its TB control program.
– The theme for World TB Day 2024, “Yes! We can end TB!”, emphasizes the potential for eradicating TB with existing resources and political will.
A 10-Point Agenda Towards Ending TB:
1. Early Detection: Early detection of TB is crucial, requiring compulsory screening for family and contacts of index cases.
2. Precise Treatment Categorization: With rising drug-resistant TB cases, knowing resistance status at diagnosis is essential for appropriate treatment.
3. Treatment Adherence and Follow-Up: Ensuring treatment compliance through innovative monitoring mechanisms is vital.
4. Zero Mortality: Mitigating TB-related mortality, including among drug-resistant cases, is imperative.
5. Controlling Drug Resistance: Addressing the man-made issue of drug resistance through better regulation and compliance is necessary.
6. Assessing Extent of Drug-Resistant TB: Data on drug-resistant TB cases aids in program planning and resource allocation.
7. Availability of Appropriate Medicines: Procurement challenges for drug-resistant TB medications must be addressed to ensure treatment access.
8. Integration into Larger Health Systems: Strengthening referral networks and integrating TB care into broader health systems improves patient outcomes.
9. Dynamic Notification System: Enhancing real-time data capture and sharing facilitates more efficient TB management.
10.Considering Population Mobility: Addressing TB in the context of population mobility requires policy-level portability of treatment.
Pledging for a TB-Free Future:
With a concerted effort focused on early diagnosis, continuous treatment, and policy improvements, the goal of a TB-free India and world is achievable
Assessing Women’s Representation in Politics and Leadership:
– The year 2024 is significant for democracy, with 45% of the global population set to exercise their voting rights.
– Despite progress, women remain underrepresented in political spheres and leadership roles.
Historical Context:
– In the latter half of the 20th century, progress was made in securing voting rights for women and increasing their presence in parliamentary bodies.
– New Zealand led the way by granting universal suffrage to women in 1893.
Gender Gap in Political Participation:
– Data shows a divergence in voting rights between men and women in the early 20th century, with men gaining rights at a faster pace.
– The gap closed as voting rights discrimination against women ended in many countries.
Representation in National Parliaments:
– Women’s presence in national parliaments remained limited until the latter half of the 20th century.
– Norway saw the entry of women into parliament in 1907, but significant increases occurred in the late 20th and early 21st centuries.
– Rwanda set a remarkable precedent by surpassing the 50% mark for women’s representation in 2008.
Continued Challenges:
– Despite progress, women’s representation in parliament remains low and uneven globally.
– Close to 60 countries have 20% or less women in parliament, with three countries having no female representation.
Representation in Highest Political Office:
– Data shows that almost all political chief executives historically have been men.
– While there has been a slight increase in women-led countries in the last three decades, they still constitute less than 10% of political chief executives.
Mumps Resurgence in Kerala:
– Mumps, a viral infection historically affecting children, has surged in Kerala, with cases also reported in Maharashtra, Telangana, and Andhra Pradesh.
– Sporadic cases in November 2023 escalated into major outbreaks across Kerala’s districts, totaling 15,637 cases by March 22, 2024.
Concerns and Complications:
Mumps typically presents with fever, headache, and painful swelling of the salivary glands, with complications such as meningoencephalitis and pancreatitis feared due to the surge in cases.Complications like encephalitis, epilepsy, and infertility have been reported, underscoring the disease’s public health significance.
Vaccination and Immunization:
– Despite being vaccine-preventable, mumps isn’t part of the Universal Immunisation Programme (UIP) due to perceived low mortality and public health significance.
– The Indian Academy of Paediatrics (IAP) highlights the underestimated public health significance and advocates for the inclusion of Mumps-Measles-Rubella (MMR) vaccine in the UIP.
Control Strategies:
– Public awareness and isolation of infected individuals are crucial for controlling transmission.
– Improving immunization coverage, particularly among unvaccinated children and adolescents, is essential to curb outbreaks.
Way Forward:
– Integration of mumps vaccination strategies with existing measles elimination and rubella control efforts is recommended by the World Health Organization (WHO).
– Kerala has urged the Centre to replace the Measles-Rubella (MR) vaccine with MMR vaccine in the UIP to address the mumps resurgence.
About Mumps:
– Mumps is a contagious disease caused by a paramyxovirus, primarily affecting children and young adults.
– It manifests with swelling and tenderness of the parotid glands, located on each side of the face.
– The virus spreads through direct contact or airborne droplets from infected individuals.
Symptoms:
– Incubation period lasts 2 to 4 weeks, followed by non-specific symptoms like myalgia, headache, and low- grade fever.
– Swelling of the parotid salivary glands, sometimes unilateral or bilateral, occurs within days.
– While mumps is usually mild and self-limiting, complications like encephalitis, deafness, and orchitis (testicular inflammation) may arise.
Treatment:
There is no specific treatment for mumps; symptom relief is managed with medications.
Prevention:
Immunization is the best preventive measure against mumps, ensuring children are vaccinated.