Bringing health and wellbeing services closer to the communities helps breaking barriers they face in accessing them. With this driving intent, few important promising initiatives are spearheaded by Indian government this fortnight. We see the Multi-Disease elimination approach in action.
Right and timely diagnosis remains a critical entry-gate towards treatment care pathway. Of course, disease prevention must take primacy, whether it is infectious diseases or non-communicable diseases (NCDs).
Health Services for Women and Girls
First such noteworthy initiative is “Swasth Nari Surakshit Parivar Abhiyan” (translates in English to “Healthy Women Protected Family campaign”) is being held across India from 17th September to 2nd October (Mahatma Gandhi’s birthday) in all government health facilities, marking the largest ever health outreach for women and children in the country.
Over a million health camps are being held as part of this campaign leveraging upon government health centres at different levels to ensure women-centric disease prevention, health promotion, and diagnostics to treatment, care and support health services reach the community level.
Breast Cancer Screening
For example, breast cancer screening is taking place with portable or point-of-care handheld and battery-operated health technologies such as ibreast-exam (developed by UE Lifesciences) in Haryana state – 9 vans with such technologies were flagged last week by Haryana Chief Minister.
Antenatal checkup, Screening for diabetes, hypertension, oral, breast and cervical cancer screening, TB, as well as linkage to appropriate treatment and care pathways has been going on different blocks of Kangra, Himachal Pradesh, India.
In Punjab state, #MadeInIndia Thermalytix breast cancer point-of-care screening test was launched in 8 districts by Punjab Health Minister Dr Balbir Singh. At least 300 breast cancer screening will be conducted daily.
Thermalytix is artificial intelligence enabled portable breast cancer screening device made by Niramai.
Breast cancer is the most common cancer among women. In 2022, around 2.3 million women were diagnosed with breast cancer and 670,000 died of it worldwide. More worrying is that breast cancer diagnosis is inequitable and wide disparities exist between high- and low-income countries.
Early and right diagnosis of breast cancer is critically important for favourable treatment outcomes. Breast cancer also occurs in men but predominantly disease- and death-burden associated with it is among women.
According to the World Health Organization (WHO), breast cancer is a disease in which abnormal breast cells grow out of control and form tumours. If left unchecked, the tumours can spread throughout the body and become fatal.
TB Screening and Diagnosis at The Doorstep
Despite being preventable and treatable, TB is the deadliest infectious disease today. It is essential that lifesaving, early and accurate screening and diagnostics for TB reaches those currently unreached.
All these 9 vans in Haryana with iBreast exam, are also equipped with #MadeInIndia ultraportable handheld X-Ray (ProRad) machines with artificial intelligence computer-aided detection of TB (and other diseases as per the AI software used).
All these 9 vans also have Truenat molecular test. Truenat is the only WHO recommended point-of-care, battery operated, laboratory independent and decentralised molecular test for TB (as well as 40 other diseases) and deployed in over 90 countries worldwide. Earlier this year, Indian government had announced country’s first indigenously developed and point-of-care HPV DNA molecular test Truenat which screens people for 8 high-risk HPV genotypes (Truenat HPV-HR Plus test). Truenat takes another hour or two to give confirmatory diagnosis.
This campaign is strengthening infectious disease screening and early and accurate detection as well as treatment linkages for non-infectious diseases (or non-communicable diseases or NCDs). Hyper-tension, anaemia, TB, sickle cell disease, breast cancer screening, promoting mother and child health, adolescent health, immunisation, nutrition, menstrual hygiene, voluntary blood donation, and lifestyle and mental health awareness are on the agenda.
Service Fortnight
Another such initiative launched by the Indian government this fortnight is called “Sewa Pakhwada” (translates in English to a service fortnight) which is also being observed across India during the same period as the above-mentioned initiative.
It engages young people too and encourages cleanliness drives, health and blood donation camps, tree plantations, youth marathons, exhibitions, and promotion of local products. Primary aim is to raise awareness and public consciousness on health, environment, and self-reliance, and serving the people and our environment.
Under this initiative, India’s national capital doubled the number of Truenat multi-disease molecular test machines. Delhi Chief Minister Rekha Gupta inaugurates 40 new Truenat machines for early and accurate TB diagnosis, almost doubling the total number of machines serving Delhi (now, over 90 machines deployed in the state).
In Goa state of India, several such initiatives are serving the people in remote areas too. For example, in village Panchayat Sao Jose De Arreal under Curtorim, South Goa district, AI-enabled ultraportable and handheld X-Rays (ProRad) are taking closer to the communities to screen them early for TB.
Goa is the first state in India that had completely replaced sputum microscopy, which underperforms in diagnosing TB, with upfront WHO-recommended molecular tests in 2021. Now, with X-Rays taken to the doorstep or closer to the communities to screen everyone – regardless of symptoms – Goa is likely to find TB early and accurately and link them to lifesaving treatment, care and support.
Multi-Disease Elimination Approach
Although progress towards delivering on #HealthForAll is dismal in the Global South, it is important to note that among some positive steps towards #HealthForAll is an effort to scale up multi-disease screening and diagnostics at the point-of-care, or better to say point-of-need for most underserved communities.
Strengthening multi-disease diagnostic infrastructure in low- and middle-income countries is important. For example, ultraportable and handheld X-Rays with AI-enabled computer-aided detection not only screen for TB but several other pathologies (depending upon the AI software used). For example, DeepTek AI’s Genki screens for over 25 pathologies and is approved by several regulators such as US FDA.
Likewise, #MadeInIndia molecular test Truenat which is the largest used molecular test in India and is also deployed in several low- and middle-income countries globally, can offer RT-PCR testing for over 40 diseases.
Point-of-care health technologies become all the more important because they can be taken closer to the people who are less likely to access public services due to a range of barriers.
All countries should fully or optimally use all diagnostics, take laboratories closer to the underserved communities, link them with treatment, care and support and ensure we are not letting disease prevention slip off the radar.
