Resilient Axshya Communities for Elimination of TB in India and mobilisation of resources through multi-sectoral engagement

The International Union Against Tuberculosis and Lung Disease (The Union) is an international scientific organization headquartered in Paris, France since 1920. Its goal is to promote national autonomy within the framework of the priorities of each country by developing, implementing and assessing anti-tuberculosis, lung health and non-communicable disease programs as well as other public health issues. Union South-East Asia (USEA), one of the organization’s largest offices since 2009, has managed USAID supported Challenge TB project and The Global Fund supported Axshya Project for more than a decade together with National Tuberculosis Elimination Program (NTEP) and provided critical support in advocacy, private sector engagement, improving working conditions for TB patients, improving access to molecular diagnostics in private sector and among children, rolling out new drugs and regimen.

In 2019, the National TB Elimination Programme (NTEP) notified over 2.4 million of estimated 2.7 million incident TB cases - missing nearly 0.3 million TB cases. Children with TB comprised just 6% of the total TB patients; while 78% of children (aged <6 years) eligible for TB Preventive Treatment (TPT) received treatment. TPT uptake among people living with HIV (newly enrolled in care) was only 17%. About 58% of notified TB cases were tested for Rifampicin Resistance. 

There is a growing acknowledgement that TB elimination targets will only be met through a multisector approach that addresses the social determinants of health, and not merely through a medical response aimed at diagnosis and treatment. Multisector collaboration is an important area to garner the support of different ministries, development partners, stakeholders and institutions to harness their expertise and influence in mobilizing resources and commitment towards TB Free India 2025. There is a need to sustain and nurture this initiative so that it translates policies into actions across various levels. Axshya-Plus consortium brings together organizations with different skill sets and experience and is thereby well positioned to kick start and accelerate multi-dimensional actions to contribute significantly to TB elimination efforts in India.

Project Axshya, a Global Fund Round 9 project, is designed to extend the reach of India’s Revised National TB Control Programme through advocacy, communication and social mobilization activities in 300 districts across 21 states. GLRA India is a sub-recipient for this project for the duration of 2021-2024. The objective of the project is to demonstrate implementation models, generate evidence, and scale-up programmatic management of TB preventive treatment. During the project, implementation of TPT models for better programmatic management of TB prevention and care services focusing on household contacts of index TB patients will be undertaken and evidence will be generated through operational research to support policies and practice. All patients on TPT will be followed from diagnosis to treatment completion by the LTBI coordinators for two years.