Since its inception in 2014, Prime Minister Narendra Modi's direct address to the citizens of India through Mann ki Baat has inspired many to come together and contribute towards the creation of a New India. The Prime Minister has spoken about tuberculosis (TB) on multiple occasions during his Mann ki Baat address, highlighting the disease and the need to battle it head-on. Under his leadership, India is spearheading the global movement to eliminate TB. He has set an ambitious goal for India to eliminate TB by 2025, five years before the global sustainable development goals (SDG) envision[1][3][5].
To fully eliminate TB from India, we need to focus on those groups of people who are more susceptible to the disease and are known to have a higher disease burden. The tribal communities are one such group. The Piramal Foundation is working with tribal communities through the Tribal TB Initiative under the larger ambit of the Tribal Health Collaborative. It is committed to end preventable deaths among the tribal and marginalized communities of India by focusing on maternal and child health issues, infectious diseases such as TB, non-communicable diseases, and sickle cell disease.
As the Collaborative focuses on bringing together public health expertise and civil society organisations to realize the collective goal of better tribal health outcomes, it is equally important that society comes together and puts up a united front in our battle against TB. As the Prime Minister says: the power of public service and public participation achieves every difficult goal with certainty. We have learned the same from our experience of implementing the Tribal TB Initiative.
The recently conducted 100-day active case-finding campaign for TB 'Aashwasan' witnessed the active participation of close to two lakh community influencers. These were powerful people from the local tribal communities who had the ability to influence decision-making. They included tribal leaders, tribal traditional healers, teachers, youth volunteers, self-help group members, panchayat representatives, TB survivors, and village elders. Their support was immense as the campaign team went to remote areas and conducted their activities, which included awareness sessions, door-to-door screening for presumptive TB, sample collection for TB testing, and so on.
The campaign also provided us an opportunity to pilot innovative, tech-based solutions, to address some of the persisting issues. For example, delays in TB testing and diagnosis are often due to the overall inaccessibility and remoteness of the tribal regions. Aashwasan presented us the platform to test the effectiveness of specially designed drones to reduce the time lags between sample collection and testing.
In his Mann ki Baat address, the Prime Minister has spoken about the need to overcome the fear of TB, encouraging people to get themselves tested and treated, as TB is a curable disease. The community influencers who worked with us during the campaign further carried this message to their respective communities, urging people to overcome their fears, correcting widespread misinformation related to the disease. We were joined in our fight against the fear and stigma associated with TB, by TB survivors and champions themselves.
Reshma, for example, a TB survivor from Barwani District in Madhya Pradesh, voluntarily joined the team when she heard about the Aashwasan campaign. She participated in several awareness activities and used the forums to share about her struggle with TB, inspiring several others to complete their treatment, and giving them hope that they, too, can become TB survivors and champions. Similarly, Disinang, a faith healer from Noney District, helped us in our mission in Manipur. After being diagnosed with TB in 2018, he had firsthand experience of dealing with stigma associated with TB. Upon recovery, inspired by his own experience, he has started using his position in the community to address stigma and fear associated with TB. He regularly motivates everyone to get screened and informs everyone that the disease is completely curable if treated on time. He too was an active member of the local campaign team.
These are two examples out of many more that we encountered during the Aashwasan campaign, all inspired by their personal experiences, to join the battle against TB. As TB gains centerstage under the leadership of our Prime Minister, it is imperative that we capitalize this momentum and take the message to the remote corners of our country. And for that, every stakeholder needs to join forces. In the Aashwasan campaign, we have seen the potential of jan bhagidari. Every member we came across during our visits to remote hard-to-reach areas supported the campaign in their own capacities.
In the hilly terrains of Arunachal Pradesh and Manipur, where accessibility was a constraint, district officials and panchayat leaders supported the local staff by facilitating local arrangements for stay. In conflict-affected areas of Jharkhand, during tense atmosphere of fear and doubt, the panchayat members took on the role of community mobilisers for TB. When women with symptoms refused to test for TB fearing stigma and social exclusion, the Anganwadi and ASHA workers came together to pacify their fears.
The Aashwasan campaign has shown us the potential of collective action and community participation. As we head towards 2025, in the Prime Minister's words, jan bhagidari to eliminate TB is taking the form of a mass movement, with people's participation, and we are showcasing the example of a true democracy—Sabka Saath, Sabka Vikas, Sabka Swastha.
(The writers are Dr. Swati Piramal & Dr. Shobha Ekka; views are personal)
This article was first published on 25 April 2023 in Mint
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