• 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