The obligatory step of Aadhar enrolment number on Aadhar has been made by The Union government for tuberculosis patients and health providers looking for cash assistance under Revised National Tuberculosis Control Programme. The notification provided by the ministry of Health and Family Welfare on Jun e 16 clearly states that – an Aadhaar authentication under National Health Mission or complete proof of Aadhar number is required for those who are eligible to receive conditional cash assistance using Nikshay. A universal access to tuberculosis (TB) care under the government health facilities and registered private health facilities spread across the country (which provide early diagnosis and regular treatment to the patients) are sponsored by Union Government.
What is Nikshay?
It is a web based application which holds the record of registered TB Patients and monitors them under the scheme of Revised National Tuberculosis Control Programme (RNTCP). Nikshay is used by all government, private healthcare providers and treatment supporters. In current scenario, private healthcare providers get Rs 100 for each notification and Rs 400 for each patient who completes treatment. Workers in villages like ASHA who are typically associated only with (DOT) directly observed treatment provider, gets an honorarium of Rs 1,000 for each TB patient and Rs 5,000 for each patient with multi-drug resistant tuberculosis. These beneficiaries will now have to provide Aadhaar-linked bank accounts.
The World Health Organisation (WHO) recommends that a TB-diagnosed patient should have six months of treatment with combination of at least three antibiotics. The major problem in India is that many patients quit the treatment midway which leads to the potential danger of developing multi-drug resistance TB.
The government is expected to spend around Rs 16,649 crore (USD 2.5 billion) on the programme for elimination of TB as part of its National Strategic Plan (NSP) for 2017-2025. Defending its move, the MoHFW in its notification said, “the use of Aadhaar as identity document for delivery of services or benefits or subsidies simplifies the government delivery processes, brings in transparency and efficiency and enables beneficiaries to get their entitlement directly in a convenient and seamless manner and Aadhaar obviates the need for producing multiple documents to prove one’s identity.”
Since, 50 years India ha been engaged in Tb control activities but Tb continues to be one of the most stubborn and incurable disease of India. More than 480,000 Indians tends to lose their life in a year because of Tb and more than 1,400 every day. There are more than a million cases of every year in India which are not notified yet. Whereas, most of the cases remain either undiagnosed or unaccountably and inadequately diagnosed and treated in the private sector.
However, analysts say mandatory Aadhar will brings transparency among the people and helps to eliminates duplicity but it also risks making TB treatment inaccessible, because most patients diagnosed with TB belong to a 'marginalized' strata of the society, living in crowded urban localities and among HIV patients and tribal populations. Many of these people have no proof of identity or residence. But if avoided then the denial of treatment could be a disaster as this not only for the patient’s mortality and more poverty but also makes more people prone to Tuberculosis.