The National TB Control Programme was launched in 1962 with the aim to detect cases earliest and treat them. In the district, the programme is implemented by the district Tuberculosis Centre (DTC) and the Primary Health Institutions. The District Tuberculosis Programme (DTP) is helped by the state level organization for the coordination and supervision of the programme. The Revamped National Tuberculosis Control Programme (RNTCP), based on the Directly Observed Treatment Short Course (DOTS) strategy, began as a pilot project in 1993 and was launched as a national programme in 1997 but rapid RNTCP expansion began in late 1998. The nation-wide connection was achieved in 2006.
The Revamped National Tuberculosis Control Programme has initiated early and firm steps to its declared objective of Universal access to early quality diagnosis and quality TB care for all TB patients’. RNTCP is being implemented with decentralized works of TB diagnosis through 13,000+ designated microscopy centers and free treatment across the nation through 4 lakh DOT centers.
The NSP 2017 – 2025 created on the success and learnings of the last NSP and encapsulates the bold and innovative steps required to eliminate TB in India by 2030. It is considered in line with other health sector strategies and global efforts, such as the draft National Health Policy 2015, World Health Organization’s (WHO) End TB Strategy, and the Sustainable Development Goals (SDGs) of the United Nations (UN).
Vision: Free India with zero deaths, disease, and poverty due to tuberculosis.
Goal: To achieve a rapid decline in the burden of TB, morbidity, and mortality while working towards the elimination of TB in India by 2025.
- The need for moving towards TB elimination have been integrated into the four strategic pillars of “Detect – Treat – Prevent – Build” (DTPB).
- Detect: Find all DS – TB, and DR – TB cases with an emphasis on reaching TB patients looking for care from private providers and undiagnosed TB in high – risk populations.
- Treat: Promote and sustain all patients on appropriate anti – TB treatment wherever they seek care, with patient-friendly systems and social support.
- Avoid the emergence of TB in susceptible populations
- Create and strengthen enabling policies, empowered institutions and human resources with enhanced capacities.
For achieving the goals of the NSP 2017 – 2025, the following critical components of the programme will be addressed on priority. The next set of actions cover:
- Ministry of Health and Family Welfare (MoHFW) will evolve a programme to address the patients seeking care in the private sector. The programme will have suitable incentives for private doctors and patients to report TB cases coupled with another scheme to grant free of cost medicines to TB patients going to a private doctor/institute.
- A robust, modern MIS system will be established to monitor the newly diagnosed as well as existing cases of TB on the delivery of the drug kit to the patient, compliance to treatment regimen etc. The MIS system will have better linkages with the private pharmacy on the sale of anti-TB drugs thereby integrating those patients into the MIS.
- The availability of quick molecular tests will be suitably augmented so that these diagnostic facilities are also made available for patients referred by any private doctor or institute.
- To enhance the compliance of the TB patients to the treatment regimen, MoHFW will start customized SMS services to the individual patients on regular basis reminding them about the time to consume the drugs.
- The MoHFW will establish mechanisms for facilitating nutritional assist to the TB patients, including financial support through DBT mode.
- The MoHFW will work on a programme to give suitable incentives to the States doing well in RNTCP. The incentives will also be linked with performance in “Swachh Bharat Mission”.
- TB Corpus Fund: To improve financial sustainability in the TB sector the programme will mobilise additional resources to accelerate TB control efforts, for which the ‘Bharat Kshay Niyantran Pratishtan’ (India TB Control Foundation) is launched. Works like nutrition support for TB patients, active case finding in prisons, slums, tribal area, sputum collection and transport in difficult areas will be carried out.