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Evolution of Revised National TB Control Program (RNTCP)

Epidemiology of Communicable DiseasesHealth Programmes in India

  • The National Tuberculosis Programme of India (NTP) was initiated in 1962 and was originally designed for
    • Domiciliary treatment, using self- administered standard drug regimens.
  • A review of the programme in 1992 concluded that the NTP was poorly managed, inadequately funded and could not achieve TB control
    • Treatment success rates was unacceptably low
    • Over-reliance on X – ray for diagnosis
    • frequent interrupted supplies of drugs
    • Default rates remained high
    • Death rates due to TB were still high
  • To overcome these shortcomings, a revised strategy to control TB was pilot-tested in 1993.
  • Encouraged by the results of Pilot tests, the Revised National Tuberculosis Control Program(RNTCP) in 1997
  • This Revised National Tuberculosis Control Programme (RNTCP)
    • Adopted the DOTS-strategy (Directly Observed Treatment, Short-course chemotherapy)
  • During the first phase, RNTCP achieved country-wide coverage in 2006.
  • RNTCP entered phase-II in 2007
    • To consolidate the gains and widen the services
    • New initiatives:
  • Wider collaboration with other sectors
  • Standardized treatment and diagnostic facility to ALL TB patients IRRESPECTIVE of the sector (private or government)
  • Improving access to marginalized population e.g. slum dwellers and tribal groups

Achievements under RNTCP (till 2016)

  • Covers the whole country since 2006
  • Treatment success rate reached 88% in 2015
  • TB Death rate declined steeply from 25% (1998) to 4% (2015)
  • CBNAAT available in almost all district level facilities
  • Although India has managed to scale up basic TB services under RNTCP, the rate of decline is too slow to meet the
    • 2030 Sustainable Development Goals (SDG) and
    • 2035 End TB targets
  • New interventions are required to hasten the rate of decline of incidence of TB to more than 10-15% annually.
  • The efforts for achieving this have compiled into the ‘NSP for TB Elimination 2017–2025’

References:

  • Park’s Textbook of Preventive and Social Medicine, Ed. 24th
  • GOI 2017, NATIONAL STRATEGIC PLAN FOR TUBERCULOSIS ELIMINATION 2017–2025: Central TB Division, Directorate General of Health Services, Ministry of Health with Family Welfare, New Delhi – 110 108