The National TB Control Programme was started in 1962 with the aim to detect cases earliest and treat them. In the district, the programme is implemented through the district Tuberculosis Centre (DTC) and the Primary Health Institutions. The District Tuberculosis Programme (DTP) is supported by the state level organization for the coordination and supervision of the programme. The Revised 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 coverage was achieved in 2006.
The Revised 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 decentralised services of TB diagnosis through 13,000+ designated microscopy centres and free treatment across the nation through 4 lakh DOT centres.
RNTCP's National Strategic Plan (NSP) 2012-17 was part of the country’s 12th Five year Plan. The theme of the NSP 2012-17 was "Universal Access for quality diagnosis and treatment for all TB patients in the community" with a target of "reaching the unreached". The major focus was early and complete detection of all TB cases in the community, including drug resistant TB and HIV-associated TB, with greater engagement of private sector for improving care to all TB patients. The NSP was backed up by GoI’s commitment for substantial increase in the investment for TB control, with a four-fold increase in budgetary allocation.
During the NSP 2012- 17 period, significant gains were made in strengthening the support structures, programme architecture and implementation environment for TB control. This includes mandatory notification of all TB cases, integration of the programme with the general health services (National Health Mission), expansion of diagnostics services, programmatic management of drug resistant TB (PMDT) service expansion, single window service for TB - HIV cases, national drug resistance surveillance and revision of partnership guidelines.
The NSP 2017 - 2025 builds on the success and learnings of the last NSP and encapsulates the bold an d innovative steps required to eliminate TB in India by 2030. It is crafted 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 : TB - Free India with zero deaths, disease and poverty due to tuberculosis.
Goal : To achieve a rapid decline in burden of TB, morbidity and mortality while working towards elimination of TB in India by 2025.
Results Framework (impact and outcome indicators and targets)
|To reduce estimated TB Incidence rate (per 100,000)||217 (112 - 355)||142 (76 - 255)||77 (49 - 185)||44 (36 - 158)|
|To reduce estimated TB prevalence rate (per 100,000)||320 (280 - 380)||170 (159 - 217)||90 (81 - 125)||65 (56 - 93)|
|To reduce estimated mortality due to TB (per 100,000)||32 (29 - 35)||15 (13 - 16)||6 (5 - 7)||3 (3 - 4)|
|To achieve zero catastrophic cost for affected families due to TB||35%||0%||0%||0%|
|Total TB patient notification||1.74 mil||3.6 mil||2.7 mil||2 mil|
|Total patient Private providers notification||0.19 mil||2 mil||1.5 mil||1.2 mil|
|MDR/RR TB patients notified||28,096||92,000||69,000||55,000|
|Proportion of notified TB patients offered DST||25%||80%||98%||100%|
|Proportion of notified patients initiated on treatment||90%||95%||95%||95%|
|Treatment success rate among notified DSTB||75%||90%||92%||92%|
|Treatment success rate among notified DRTB||46%||65%||73%||75%|
|Proportion of identified targeted key affected population undergoing active case finding||0%||100%||100%||100%|
|Proportion of notified TB patients receiving financial support through DBT||0%||80%||90%||90%|
|Proportion of identified/eligible individuals for preventive therapy / LTBI s - initiated on treatment||10%||60%||90%||95%|
The requirements for moving towards TB elimination have been integrated into t he four strategic pillars of "Detect - Treat - Prevent - Build" (DTPB).
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 include:
A national level annual review of the programme will be undertaken by the TB elimination board chaired by the Prime Minister’s Office (PMO). Apart from the SDG related indicators the review will also track programme performance and provide directives to enhance the ease of programme implementation at all levels.
To access the complete NSP document, click here.
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