Yes! We Can End TB

Dr. Balamurugan

Hello and welcome to a special edition of our podcast, 'Yes! We Can End TB!' Today is March 24, 2025 – World TB Day, a day dedicated to raising awareness about tuberculosis (TB), its impact, and the ongoing fight to eliminate it. TB is an ancient disease, yet it remains one of the deadliest infectious diseases today. This year, we focus on India’s ambitious goal to eliminate TB by 2025—five years ahead of the global target. I’m joined by an esteemed expert in lung health, Dr. Sangamithra, a leading pulmonologist with vast experience in TB diagnosis and treatment. Welcome, Dr. Sangamithra! It’s an honor to have you here for this special discussion.

Dr. Sangamithra

Thank you, Dr. Balamurugan! I’m excited to be here and talk about this important public health issue. TB is a critical topic, and I’m glad we can shed light on it today.

Dr. Balamurugan

Absolutely! Let’s start with the big picture. TB has been around for centuries, yet it still claims millions of lives worldwide. Could you share some statistics on the global burden of TB? I think it’s important for our listeners to understand the scale of this issue.

Dr. Sangamithra

Absolutely, Dr. Balamurugan. Tuberculosis (TB) remains one of the top 10 causes of death globally and is caused by the bacterium Mycobacterium tuberculosis. In 2023, 10.6 million people fell ill with TB, and 1.3 million people died due to it. TB is also a leading cause of death among people living with HIV/AIDS, and drug-resistant TB (MDR-TB and XDR-TB) is increasing, making treatment more difficult. These numbers are truly alarming and highlight the urgency of our mission to eliminate TB.

Dr. Balamurugan

Those statistics are indeed alarming. Despite being preventable and curable, TB continues to spread and kill millions. Why is this happening? What are the main barriers to effective TB control?

Dr. Sangamithra

Several factors contribute to this crisis. Delayed diagnosis is a major issue—many people don’t recognize TB symptoms or seek medical care late. Treatment non-adherence is another significant problem; TB requires 6 months or more of strict medication adherence. If patients discontinue treatment early, it leads to drug-resistant TB. Limited healthcare access, especially in low-income countries, is also a factor. HIV-TB co-infection, where people living with HIV are at higher risk of TB due to a weakened immune system, and social stigma, which can prevent patients from seeking timely care, are additional barriers.

Dr. Balamurugan

That’s a comprehensive overview. So, despite the availability of treatment, barriers like stigma, poor healthcare access, and drug resistance are fueling this crisis. That’s why awareness is crucial. Now, let’s break it down for our listeners. What exactly is TB, and how does it spread? I think understanding the basics is essential for everyone.

Dr. Sangamithra

Tuberculosis (TB) is an airborne infectious disease that mainly affects the lungs but can also spread to other organs like the brain, kidneys, and spine. TB spreads when an infected person coughs, sneezes, or talks, releasing bacteria into the air. People nearby inhale these bacteria, which can cause infection. There are two types of TB infections: latent TB, where the bacteria are dormant and the person shows no symptoms, but can activate if the immune system weakens, and active TB, where the bacteria multiply, causing severe symptoms and making it highly contagious.

Dr. Balamurugan

That’s a clear explanation. Dr. Sangamithra, what are the common symptoms of TB that people should watch out for? Early detection is critical, so it’s important for our listeners to know what to look for.

Dr. Sangamithra

The classic symptoms of active TB include a persistent cough for more than two weeks, fever and night sweats, unexplained weight loss, fatigue and weakness, chest pain and difficulty breathing, and in severe cases, coughing up blood. These symptoms can vary, but they are red flags that should prompt immediate medical attention. Early detection is indeed critical, as it can significantly improve treatment outcomes.

Dr. Balamurugan

That’s why early detection is so crucial. How is TB diagnosed? What are the main methods used to identify TB in patients?

Dr. Sangamithra

TB diagnosis involves several methods. Sputum microscopy and culture are used to test phlegm for TB bacteria. The GeneXpert test is a rapid test that can also detect drug resistance. Chest X-rays help identify lung damage, and the Tuberculin Skin Test (TST) and Interferon-Gamma Release Assays (IGRA) are used to detect latent TB infections. These tests are essential for accurate diagnosis and appropriate treatment.

Dr. Balamurugan

Thank you for that detailed explanation. TB is curable, but treatment has its challenges. Can you explain the standard TB treatment and the difficulties in managing it? I think understanding the treatment process is crucial for supporting those affected by TB.

Dr. Sangamithra

The standard TB treatment is a 6-month antibiotic course, typically involving drugs like Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol. The DOTS (Directly Observed Treatment, Short-course) program ensures treatment adherence. However, there are significant challenges. Drug-resistant TB requires longer, more expensive treatment. Patients sometimes stop medication early, leading to relapses and resistance. Managing TB in HIV patients is complex, and social stigma can prevent patients from seeking timely care. These challenges highlight the need for ongoing research and improved healthcare policies.

Dr. Balamurugan

Absolutely. Awareness, early diagnosis, and complete treatment adherence are key to fighting TB. This year’s World TB Day theme is 'Yes! We Can End TB: Commit, Invest, Deliver.' Dr. Sangamithra, what does this theme signify, and how does it relate to our efforts to eliminate TB?

Dr. Sangamithra

The theme 'Yes! We Can End TB: Commit, Invest, Deliver' emphasizes the importance of commitment from governments, investment in research and healthcare, and ensuring universal access to treatment. Commitment means prioritizing TB elimination in national health agendas. Investment is crucial for funding research, vaccines, and new diagnostic tools. Delivery ensures that everyone, regardless of their location or economic status, has access to the treatment they need. This theme underscores the collective effort required to achieve our goal.

Dr. Balamurugan

That’s a powerful message. India aims to eliminate TB by 2025. What are the key strategies under the National Strategic Plan (NSP) to achieve this ambitious goal? I think our listeners would be interested in the specific steps being taken.

Dr. Sangamithra

The NSP has several key goals. It aims for a rapid decline in TB cases and deaths, strengthening TB detection and treatment, ensuring zero catastrophic costs for TB patients, and leveraging AI, digital health, and new vaccines. These strategies include improving healthcare infrastructure, enhancing community engagement, and implementing innovative technologies to detect and treat TB more effectively. The plan is comprehensive and reflects a multi-faceted approach to TB elimination.

Dr. Balamurugan

Those are impressive strategies. Ending TB requires everyone’s effort! Here’s what YOU can do: spread awareness, encourage early screening, support TB patients, and advocate for better healthcare policies. Dr. Sangamithra, do you have any final thoughts or messages for our listeners?

Dr. Sangamithra

Absolutely! Ending TB is possible, but only if we work together. Every individual can make a difference by being informed, supportive, and proactive. Let’s make TB history! Together, we can achieve this goal and create a healthier, TB-free world.

Dr. Balamurugan

Thank you, Dr. Sangamithra, for your invaluable insights and expertise. And thank you, dear listeners, for joining us on this special World TB Day 2025 podcast. Let’s make TB history! Yes! We CAN End TB! Until next time, stay safe and healthy!