Nikshay Poshan Project

Layman understanding of TB is that
• the bacteria is more or less omnipresent,
• that majority of us are infected; and
• that the effects would show only when our immune systems were severely compromised.
• in India it is malnutrition
• globally, HIV patients were particularly susceptible.
But while poverty is still the culprit, TB sems to have breached the class barrier. Reason being a general lowering of immunity because of new urban ways of living, including poor dietary habits.
Facts about TB:
(a) TB can be extremely infectious
(b) Pulmonary TB —the prototypical sort that affects the lungs—is not the only type. And each makes for its own special kind of complication. TB bacteria is an extremely tenacious resisting treatment which is usually a long and torturous process, involving often months of the strictest multi-drug regimen. If guards are lowered because one felt better and missed a dose, woe betide, the bacteria goes berserk, adapts leaving no option other than a more harsh medication.
Drug-resistant tuberculosis
The rise in the number of cases and deaths due to drug-resistant tuberculosis is proving to be an impediment to India's ambition to end the disease by 2025.
According to the World Health Organization (WHO), India’s count of 119,000 makes up more than 26% of global cases of MDR-TB. “DR-TB is of growing concern in India,” acknowledges C. Padmapriyadarsini, director of the ICMR-National Institute for Research in Tuberculosis (NIRT) in Chennai. She red-flags a few key drivers: irregular treatment, delay in approaching a health facility that precludes early and prompt diagnosis, and the discontinuing of medication before its prescribed course ends.
The spectre of TB not only continues to haunt India, becoming stronger in newer and more dangerous ways due to antibiotic use and misuse.
 The TB bacteria mutates and becomes resistant to anti-TB drugs. This form, known as Multi-Drug-Resistant (MDR) TB, and the more potent version, Extensively Drug-Resistant (XDR) TB —are rising alarmingly of late.
 MDR-TB is resistant to isoniazid and rifampicin and XDR-TB is resistant to rifampicin, any fluoroquinolone, and at least one of the three injectible second-line drugs—amikacin, kanamycin or capreomycin. In recent years, DR-TB has begun to be treated with two oral drugs—bedaquiline and delamanid—which are available at government hospitals or at designated private hospitals. These drugs are more effective and have fewer side-effects than the older ones used for DR-TB.
 Pulmonary TB is highly infectious. People with active TB can infect five to 15 people through close contact over the course of a year. The disease spreads through the air when an infected person coughs or speaks. When another person breathes in the bacteria, it settles in the lungs, where it can lie dormant, a stage called latent TB infection, or develop into full-blown disease.
Social stigma is one reason why TB goes undiagnosed. Though it has breached the class barrier, “TB remains a disease of the poor,” says Blessina Kumar, CEO of the Global Coalition of TB Advocates, and a survivor herself. “And the burden is usually the patient’s to bear alone.” They either don’t go for diagnosis out of fear or stop.
Crippling Expenses is the other reason why TB goes undiagnosed
 DR-TB treatment can take up to two years, compared to six months for regular TB.
One of the main reasons why the bacteria turn drug-resistant is that treatment is stopped midway rather than continuing the regimen for the requisite six months or more. It is also why the government chose to extend its earlier Directly Observed Therapy (DOT) programme, as part of which designated health workers ensured that TB patients took their prescribed drugs daily and varied them according to the healing prognosis.
Government Initiatives
Government is concentrating on diagnostics. DR-TB requires specialised tests to detect drug resistance. These tests are often expensive and not widely available, particularly in low-resource settings. “The gold standard for identifying drug-resistant TB remains the conventional culture-based test,” says Dr Bornali Dutta, director of respiratory medicine at Medanta – The Medicity, Gurugram. “But since the TB bacteria grows slowly, it can take two weeks before results are known.”
Various state governments have now started building partnerships to improve diagnosis.In fact, the largest number of TB cases are diagnosed and treated in the private sector. Haryana is showing the way. Gurugram’s Medanta hospital is working with the state in the mission to end TB by 2025.
The two new drugs for DR-TB—bedaquiline and delamanid, are provided free of cost by the government as of now. Since affordability remains a bottleneck, the government has launched several schemes to help patients.
o The Jan Arogya Yojana is one lifeline,
o the government also provides financial assistance of Rs 500 per patient under the Ni-kshay Poshan Yojana and free medicines through government hospitals.
Dr Lucica Ditiu, executive director of the Stop TB – Partnershipis of the opinion that, “India is inspiring the world in TB elimination. Every country should have the Ni-kshay Mitra initiative. I salute the way it is happening at sub-national levels too, not in pilot mode but at scale,” she said.
But the question isn’t whether we can end TB by 2025. The goal is strictly aspirational; what it can do is accelerate the momentum on the intent to eliminate a disease that has consumed us for so long.


SAHAS Initiative
SAHAS registered as a Ni-Kshay Mitra partner in 2023. With funds raised from Trustees, SAHAS has adopted 10 poor and needy TB patients for a year in March 2024. As the world celebrates the ‘World TB Day’ on March 24, SAHAS has distributed WHO approved dry nutritious food packets to these 10 TB patients adopted by them. Over a period of the next 11 months, the same nutritious, WHO approved food packets will continue to be suppied to these 10 TB patients. Progress of 10 patients will be observed on the link provided by the Govt.
An Appeal
We are hoping that you and many more like minded persons will be willing to sponsor at least one patient for a year...cost would be around just about Rs. 1000/- a month.