Despite receiving free treatment under India’s National TB Elimination Programme (NTEP), tuberculosis (TB) patients in Arunachal Pradesh continue to face substantial financial burdens, a new study has revealed.
The study, conducted by Dr. Nagaraja Rao, a scientist at the Indian Council of Medical Research–National Institute for Research in Tuberculosis (ICMR-NIRT), was made available to Science Nigeria on Tuesday in Abuja.
Titled “Economic Burden Among Drug-Sensitive TB Patients Treated in the Public Sector Under the National TB Elimination Programme in India,” the research highlights significant gaps in the implementation of the direct benefit transfer (DBT) scheme designed to support TB patients with nutrition and essential non-medical needs.
Conducted across 12 districts in Arunachal Pradesh between October 2022 and March 2023, the study found that over 44 per cent of TB patients incurred catastrophic health expenditures, defined as out-of-pocket expenses exceeding 20 per cent of their annual household income.
While the NTEP ensures the provision of free anti-TB medicines and diagnostics, the study discovered that patients continue to bear the cost of non-medical expenses such as transportation, nutritional supplements and income loss due to illness. These indirect costs often place families under severe economic stress.
Rao noted that although the DBT scheme is a valuable component of TB care, its impact is weakened by delays in disbursement and limited patient awareness. “Only 81 per cent of eligible patients reported receiving at least one installment of DBT, and many complained that the payments arrived late or were insufficient to cover their basic needs,” he said.
The findings underscore the need to strengthen the delivery and accessibility of DBT payments, particularly in remote and underserved areas like Arunachal Pradesh.
“The World Health Organisation recommends that no TB-affected household should suffer financial hardship due to the disease. However, our study indicates that this goal remains distant in regions like Arunachal,” Rao stated.
Public health experts are calling on the Indian government to improve financial protection mechanisms, accelerate DBT processing, and intensify community-level awareness campaigns to ensure that TB patients can recover without falling deeper into poverty.
