The World Bank and the Government of India signed here today a Loan Agreement of $400 Million to expand the coverage and the quality of interventions for the control of Tuberculosis (TB), which kills approximately half a million people in India every year. The World Bank supported program will cover nine States of India.
The World Bank’s Program Towards Elimination of Tuberculosis will support the Government of India’s (GoI) National Strategic Plan to end TB in India by 2025. It will do so by helping improve and strengthen diagnostics and management of drug-resistant tuberculosis and increase the capacity of public institutions engaged in monitoring and treating TB in the country.
The World Bank and Govt. of India has over a two-decade long successful partnership in TB control. The Bank’s support since 1998 has contributed to scaling up of Directly Observed Treatment and services to poor and high-risk groups, including tribal households, HIV patients, and children; universal access to diagnostics and quality TB care; and initiation of multi-drug resistant TB services.
“India’s Tuberculosis Control Program has substantive national and global public health and economic development implications,” said Mr. Sameer Kumar Khare, Additional Secretary, Department of Economic Affairs, Ministry of Finance. “The Government of India’s National Strategic Plan is a transformative program and the World Bank support through the Program for Elimination of Tuberculosis will bring India closer to achieving the target of eliminating TB by 2025.”
The Loan Agreement was signed by Mr. Sameer Kumar Khare, Additional Secretary, Department of Economic Affairs, Ministry of Finance on behalf of the Government of India and Mr. Shanker Lal, Acting Country Director, on behalf of the World Bank.
“TB predominantly affects the poor and marginalized and kills approximately 480,000 people every year in India. Through our support to this Program, the World Bank is fulfilling its partnership commitment to the country to invest in its human capital by supporting efforts to tackle infectious diseases having substantial health and economic impacts,” said Mr. Junaid Ahmad, Country Director, World Bank.
Drug resistant TB is a major public health threat and despite a growing number of TB cases being notified, India has more than a million “missing” cases every year with most of them being either undiagnosed or inadequately diagnosed and treated in the private sector. It is further exacerbated by delayed care-seeking by suspected TB patients, low adherence to treatment, and fragmented health care service providers, including an unregulated private sector which is treating more than half of TB cases in India. Such cases represent the greatest challenge facing TB control in India.
The Program seeks to ensure that these private sector providers adhere to established protocols of timely diagnosis, notification and effective management of TB. The Program will provide financial incentives to private sector care providers for reporting cases of TB and ensuring that their patients complete the treatment regimen. It will also provide Direct Benefit Transfers to patients for acquiring the critical nutrition needed during treatment. The Program will help the GoI strengthen the monitoring and implementation of Nikshay – a web-based TB case monitoring system introduced by the government.
The Program will also strengthen the detection, treatment and monitoring of Drug-Resistant Tuberculosis and will track progress in detection of additional drug resistance. It will also support the Ministry of Health and Family Welfare to develop and implement a human resource plan to meet institutional capacity needs at the Centre and State level, for the successful implementation of the NSP.
“The Program incorporates Indian and global best practices in private provider engagement for TB control, patient support interventions and capacity building. The Program is designed in close coordination with relevant development partners, including the Bill and Melinda Gates Foundation and the WHO,” said Mr. Ronald Upenyu Mutasa, World Bank Task Team Leader for the Program. The $ 400 Million loan from the International Bank for Reconstruction and Development (IBRD) has a 19-year maturity which includes a 5-year grace period.