BCG vaccine against TB: 100 years and counting

Context:

The Bacillus Calmette–Guérin (BCG) vaccine has been used since 1921 to prevent tuberculosis (TB) and 2021 marks 100 years of BCG.

Relevance:

Prelims, GS-III: Science and Technology, GS-II: Social Justice (Issues related to Health, Government Policies and Initiatives)

Dimensions of the Article:

1. What is BCG Vaccine?
2. What is Tuberculosis?
3. Achievements highlighted in the Annual TB Report
4. BCG Vaccine for TB
5. Nikshay Poshan Yojana (NPY)

What is BCG Vaccine?

• Bacillus Calmette–Guérin (BCG) vaccine is a vaccine primarily used against tuberculosis (TB).
• In countries where tuberculosis or leprosy is common, one dose is recommended in healthy babies as close to the time of birth as possible.
• In areas where tuberculosis is not common, only children at high risk are typically immunized, while suspected cases of tuberculosis are individually tested for and treated.
• Adults who do not have tuberculosis and have not been previously immunized but are frequently exposed may be immunized as well.
• BCG also has some effectiveness against Buruli ulcer infection and other nontuberculous mycobacteria infections.
• Additionally it is sometimes used as part of the treatment of bladder cancer.
• India and Pakistan introduced BCG mass immunization in 1948, the first countries outside Europe to do so.

What is Tuberculosis?

• Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria belonging to the Mycobacteriaceae family consisting of about 200 members.
• Most infections do not have symptoms, in which case it is known as latent tuberculosis.
• The bacteria that cause TB are spread when an infected person coughs or sneezes.
• In 15–20% of active cases, the infection spreads outside the lungs, causing other kinds of TB.
• TB is a very ancient disease and has been documented to have existed in Egypt as early as 3000 BC.
• In humans, TB most commonly affects the lungs (pulmonary TB), but it can also affect other organs (extra-pulmonary TB).
• Other historically dreaded diseases like smallpox, leprosy, plague and cholera have been either eradicated or controlled to a large extent due to advances in science and technology.
• However, TB continues to be a major public health problem in the world.
• According to the WHO’s Global TB Report, 10 million people developed TB in 2019 with 1.4 million deaths. India accounts for 27% of these cases.

Achievements highlighted in the Annual TB Report

• 2019 has amounted to a 14% increase in TB notification as compared to the year 2018.
• A near-complete on-line notification of TB patients through the NIKSHAY system has been achieved.
• Reduction in the number of missing cases to 2.9 lakh cases as against more than 10 lakhs in 2017 has been achieved.
• Expansion of treatment services has resulted in a 12% improvement in the treatment success rate of notified patients.
• NIKSHAY also expanded the provision of four Direct Benefit Transfers (DBT) schemes of the programme –
  1. Nikshay Poshan Yojana (NPY) to TB patients
  2. The incentive to Treatment Supporters
  3. Incentive to Private Providers and
  4. Transport incentive to TB patients in the notified tribal areas

Other Details

• Revised National Tuberculosis Control Program (RNTCP) has been renamed to National Tuberculosis Elimination Program (NTEP).
• India is committed to achieving the SDG goal of eliminating TB in the country by 2025, five years ahead of the Global Target at 2030.
• The salient feature of this year is that for the first time Central TB Division (CTD) introduced a quarterly ranking on TB elimination efforts by all the states and UTs.

BCG Vaccine for TB

• BCG was developed by two Frenchmen, Albert Calmette and Camille Guerin, by modifying a strain of Mycobacterium bovis (that causes TB in cattle) till it lost its capacity to cause disease while retaining its property to stimulate the immune system.
• It was first used in humans in 1921.
• Currently, BCG is the only licensed vaccine available for the prevention of TB.
• It is the world’s most widely used vaccine with about 120 million doses every year and has an excellent safety record.
• In India, BCG was first introduced in a limited scale in 1948 and became a part of the National TB Control Programme in 1962.
• India is committed to eliminate TB as a public health problem by 2025.

Effectiveness of BCG

• One intriguing fact about BCG is that it works well in some geographic locations and not so well in others.
• Generally, the farther a country is from the equator, the higher is the efficacy.
• In children, BCG provides strong protection against severe forms of TB.
• This protective effect appears to wane with age and is far more variable in adolescents and adults, ranging from 0–80%.
• In addition to its primary use as a vaccine against TB, BCG also protects against respiratory and bacterial infections of the newborns and other mycobacterial diseases like leprosy and Buruli’s ulcer.
• It is also used as an immunotherapy agent in cancer of the urinary bladder and malignant melanoma.

Nikshay Poshan Yojana (NPY)

• Nikshay Poshan Yojana (NPY) is a direct benefit transfer (DBT) scheme for nutritional support to Tuberculosis (TB) patients rolled out by Ministry of Health and Family Welfare.
• The scheme is a Centrally Sponsored Scheme under National Health Mission (NHM).
• This scheme is implemented across all States and UTs in India.
• All TB patients, including all existing TB patients under treatment are eligible to receive incentives.

Note: The scheme is not related to Poshan Mission which is an initiative of Ministry of Women and Child Development.

-Source: Indian Express