Introduction
In the pursuit of achieving status of a TB-free nation, India has set an ambitious target of eliminating tuberculosis by 2025, five years ahead of the global goal set for 2030. However, the success of such a vision hinges not only on medical interventions but also on addressing the pervasive issues of under nutrition, accessibility to nutritious food, and the enduring stigma associated with TB.
India bears a significant burden, accounting for approximately one-fourth of the world's total TB cases. While medical advancements have improved treatment outcomes, the impact of under nutrition on TB treatment cannot be understated. Scientific evidence underscores the interplay between nutrition and the body's ability to combat infections, making it imperative to address malnutrition concurrently with TB treatment.1
The relationship between under nutrition and TB is bidirectional. On one hand, TB often leads to weight loss and nutritional deficiencies, exacerbating the patient's health. On the other hand, under nutrition weakens the immune system, making individuals more susceptible to TB infection and hindering recovery.2
Recognizing this critical link, the Government of India initiated the Pradhan Mantri TB Mukt Bharat Abhiyan (PMTBMBA) on September 9, 2022. This initiative introduced the concept of Nikshay Mitra, a companion dedicated to supporting TB patients throughout their treatment journey.
A key component of the PMTBMBA is the provision of a nutritious eatables kit bag on a monthly basis to TB patients. This not only addresses the nutritional needs of the patients but also establishes a compassionate connection between the Nikshay Mitra and the individual undergoing treatment. Creating a support system that goes beyond medical assistance is crucial for motivating and ensuring the completion of the often lengthy and challenging TB treatment regimen.
Moreover, the Nikshay Mitra role extends beyond nutritional support. They can play a pivotal role in reducing the stigma associated with TB by fostering understanding and empathy within communities. TB continues to be linked with underlying issues of poverty, and the stigma surrounding the disease further compounds the challenges faced by those affected.
In addition to nutritional support, the Nikshay Mitra may facilitate job opportunities for patients or their family members, offering a comprehensive approach to address financial insecurities. This holistic approach recognizes the multifaceted nature of the challenges associated with TB and aims to create a conducive environment for successful treatment outcomes.
Uttarakhand state proactively carried out the pradhanmantri TB Mukt Bharat Abhiyan all over the state. As on 16th November 2023, total of 9648 Nikshay Mitra are registered in the state who are providing the support to TB patients. A total of 18826 TB patients has benefited with the scheme, as either already taken support from Nikshay Mitra or currently on support. Various models of support from Nikshay Mitra in state are currently going on. There are individual Nikshay Mitra supporting individual patients or a group of patients. Non-governmental organisations or also playing role as a Nikshay Mitra and supporting TB patients. There are also corporate sectors which are supporting TB patients through Corporate Social Responsibility (CSR) funds.
The support mechanisms offered by Nikshay Mitra in Uttarakhand are diverse and inclusive. Individual Nikshay Mitra are actively engaged in providing personalized assistance to TB patients, ensuring a tailored approach to each individual's needs. Non-governmental organizations (NGOs) have stepped forward as Nikshay Mitra, extending their resources and expertise to contribute to the cause. Their involvement demonstrates the collaborative nature of the initiative, bringing together government bodies, individuals, and organizations to collectively combat tuberculosis.
Furthermore, the corporate sector in Uttarakhand has embraced its social responsibility by supporting TB patients through corporate social responsibility (CSR) funds. This involvement reflects a holistic approach to public health, where both governmental and private entities collaborate to address the multifaceted challenges posed by TB.
Impact of Corporate Social Responsibility as a Niksahy Mitra Improving TB Treatment Success Rates in Haridwar, Uttarakhand
In the ongoing battle against tuberculosis (TB), collaborative efforts involving corporate social responsibility (CSR), non-governmental organizations (NGOs), and health authorities have shown promising results in Haridwar, Uttarakhand. This report highlights the findings of improved treatment success rates in a cohort of 304 TB patients supported by a unique mix of CSR initiatives through an NGO, operating under the supervision of District and State health authorities.
In 2022, the treatment success rate of TB patients in Uttarakhand State was 87%, while the national average for the same year was 85.5%. These figures set the backdrop for the challenges faced in TB treatment across the country and the need for innovative models of support.
Table 1 presents the TB treatment success rates in Haridwar district over the past four years, providing a comprehensive overview of the historical context and trends.
On 27th December 2022 the Indian Oil Corporation Ltd. (IOCL) supported 304 TB patients of Haridwar district. The Nutrition kit bags distribution was facilitated through a non-governmental organization Rajat Shahri Evam Gramothan Sansthan, Haridwar on a monthly basis.
The NGO played a pivotal role in connecting regularly with TB patients, distributing food bags, and providing essential psycho-social support. Concurrently, the district and state TB cell ensured robust monitoring of the entire process. Regular health condition assessments of TB patients were conducted and the consistencies of treatment regimen were ensured. Essential diagnostics tests were conducted at regular intervals to ensure comprehensive healthcare for the patients.
Results
The preliminary findings indicated a significant improvement in the treatment success rates of the cohort of 304 TB patients under this innovative model of CSR-driven support. Out of total 304 patients a total of 287 i.e. 94% achieved TB treatment success. No mortality or lost to follow up for any patient was reported in the supported cohort.
Conclusion
The cohort of 304 TB patients, supported by IOCL in collaboration with NGO, exhibited a remarkable treatment success rate of 94%. Notably, no mortality was observed within the cohort, and there were no cases of patients lost to follow-up. These outcomes demonstrated the effectiveness of engaging Nikshay Mitra as companions to TB patients, highlighting the positive impact of the Pradhan Mantri TB Mukt Bharat Abhiyan. The collaborative approach, blending corporate support, NGO facilitation, and government oversight, has created a holistic system that addresses both medical and socio-economic aspects of TB treatment.
Way Forward
With the available evidence of improved success rate in the supported cohort of TB patients the Indian Oil Corporation Limited is extending the support to 501 more TB patients in Haridwar district under the same CSR-NGO driven model.
The success witnessed in Haridwar district serves as a testament to the positive impact of CSR initiatives, community engagement, and government collaboration in enhancing TB treatment outcomes. As we continue to face the challenges of TB on a national and global scale, these innovative models offer hope and insights for future strategies in the fight against tuberculosis. The adoption of such comprehensive approaches holds the potential to transform TB treatment paradigms and move us closer to the goal of a TB-free nation.
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