What is the necessity for the government of India to bring its TB and HIV programmes together? Also explain the recently launched "Universal Drug Sensitivity Test" to combat TB in India.

As per WHO’s TB statistics, 2015, India has 2.2 million cases of TB for India out of 9.6 million global cases. One of the major issues in case of TB is the drug resistance. Around 3% of new TB cases and 18% of prevalent cases are drug resistant cases. In order to tackle the issues of drug resistance, health authorities are planning to have a nationwide program to test every tuberculosis patient in order to find out the signs of resistance to first-line drugs.
This will not only provide the true assessment of cases of drug resistance, it will also help in finding the hidden cases of tuberculosis as well as the patients with multiple infections of TB and HIV (human immunodeficiency virus). Therefore this will help in detection of the both TB & HIV cases.
The government has also formalized a new policy, Universal Drug Sensitivity Test, to be implemented using a molecular diagnostic test called GeneXpert which is a US developed technology tool. The key aspect is that both TB bacterium, as well as resistance to rifampicin(TB drug), can be detected within 90 minutes. The problem with conventional tests was that they used to take at least a day or more and would require well-trained personnel for similar results. This can help in resolving the problem of delay in diagnosing drug resistance.
However, the problem with GeneXpert is that it is expensive and require air-conditioned settings and reliable electricity access for optimal output. The Indian Council of Medical Research is working on the development of the cheaper alternative to GeneXpert to be known as Truenat MTB, which would be more portable, battery-operated, and performs as well at lower costs.
The problem in the treatment of TB is that due to lack of proper diagnosis cases of TB are under-reported and, and a shift towards the system of molecular diagnostics will help in early detection and therefore timely treatment.


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