1. National Tuberculosis Elimination Programme
(NTEP)
Facilitator : Dr.Manisha Gohel
Presenter:
Dr.Darshna Sarvaiya , Third Year Resident
Department of Community Medicine

2. • To describe magnitude of TB Problem
• To explain evolution of TB Control Strategies in India
• To enlist goals, objectives of NTEP
• To summarize newer initiatives under NTEP
Objectives

3. Tuberculosis (TB) is an infectious
disease caused by the bacterium
Mycobacterium tuberculosis
(MTB)
Tuberculosis generally affects the
lungs, but can also affect other
parts of the body
One patient with infectious
pulmonary TB if untreated can
infect 10-15 persons in a year
What is Tuberculosis ?

4. o Malnutrition
o Diabetes
o HIV infection
o Low body weight
o Severe kidney disease
o Other lung diseases (silicosis)
o Substance abuse etc.
o Overcrowding
o Inadequate ventilation
o Enclosed living/working
conditions
o Occupational risks
Environmental
Medical
Risk Factors

5. India is the highest TB burden country
• India - 26%
• Indonesia – 10%
• China – 10%
• Nigeria – 06%
• South Africa – 04%
• Pakistan – 03%
Total 60% global burden of TB disease lies within 6 countries
TB High Burden Countries

6. The TB threat is REAL in India
10 million
people fell ill from
TB
1.4 million
people died from
TB
4.6 lakh
people had drug-
resistant TB
Missing
million TB
patients
1 patient
dies every
minute
Less than
50% treated
successfully
WHO Global TB Report 2020

7. TB Notification Progress under NTEP
WHO Global TB Report 2020

8. National Tuberculosis Control Programme (NTCP)
(1962 – 1997)
Revised National Tuberculosis Control Programme ( RNTCP)
(1997 – 2020)
National Tuberculosis Elimination Programme (NTEP)
( 2020 – till date)

9. The India’s Tuberculosis (TB) control
programme got rechristened to National
Tuberculosis Elimination Programme
(NTEP) from Revised National
Tuberculosis Control programme
Programme (RNTCP) on 1st January ,
2020
Transition from RNTCP  NTEP

10. • India has committed to end TB by 2025, 5 year
ahead of the global SDG target
• Prime Minister of India launched TB free India
campaign at “Delhi End TB Summit” on 13th
March, 2018
• The campaign calls for a social movement
focused on patient – centric and holistic care
driven by integrated actions for TB free India
TB Free India Campaign

11. • To reduce mortality and morbidity From TB
• To interrupt chain of transmission until TB ceases to be a public health
problem in India
Goals

12. • To reduce incidence of TB and mortality due to TB
• To prevent emergence of drug resistance and effectively manage drug –
resistance TB
• To improve outcomes among HIV – infected TB Patients
• To decentralize and align RNTCP management units with NHM block level
units within general health system
Objectives – to achieve TB Free India

13. India: MDG6 TB target
TB REVERSED
Rate
per
100,000
population
50%
35 lakh
additional
lives saved
50%
New cases
declining
All cases reduced
by half
Deaths reduced
by half
HIV
WHO Global TB Report 2016
465  195 per lakh pop
(58% reduction) 38  17 per lakh pop
(55% reduction)
216  167 per lakh pop
(23% reduction)

14. Vision: A world free of TB
Zero TB deaths, Zero TB disease, and Zero TB suffering
Goal: End the Global TB Epidemic (<10 cases per 100,000
population)
Sustainable Development Goals (SDG)
INDICATORS
TARGETS
SDG 2030
Reduction in number of TB deaths
compared with 2015 (%)
90%
Reduction in TB incidence (new case) rate
compared with 2015 (%)
80%
TB-affected families facing catastrophic
expenditures due to TB (%)
Zero

15. TB Elimination

16. Infrastructure Scale Up
TB Microscopy
Centre
Molecular Testing
Lab
Financial
Allocation

17. Mitigation Measures during the pandemic
• Directives for uninterrupted TB Services
• Bi – directional TB – COVID Screening
• Telemedicine and Active Case Findings (ACF)
• Scale up of Platform technologies
• PPEs for staff & door – step sample collection and
delievery of drugs
• Timely release of benefits under Nikshay Poshan
Yojana
• E – trainings and periodic review with States /
Districts at all levels
Achievements – 2020
• HIV Status known: 92%
• UDST Offered: 67 %
• Treatment Success Rate : 82%
• DR TB Treatment Initiation : 86%
• Nikshay Poshan Yojana Paid : 62%

18. Strengthening Case Findings
• Population Levels Screening followed by
Active Case Finding among Vulnerable &
comorbid
• Extrapulmonary diagnosis Medical College
involvement
• Decentralizing TB Services to HWCs
• Intensified Case Findings in other OPDs like
NCD / HIV
• Mandatory Notification – Gazette
• Schedule H 1 Surveillance
• Incentives for providers and informants
Public Private

19. TB MUKT BHARAT
January Active Case Findings
February Orienting Elected Representatives on TB
March World TB Day
April Engaging Communities through – HWCs
May TB Free Workplaces
June TB & Women
July Engaging Religious Leaders & PRIs
August TB Prevention & Lung Health
September TB & Nutrition
October Engaging Children & Youth
November TB Camps
December Stigma Mitigation

20. Subnational Certification of TB Free Status

21. Subnational Certification Awards – 2020

22. Community Engagement
National TB Forum
State TB Forum
District TB Forum
Block TB Forum
TB Champion & Patient
Support Group
• National TB Forum Constituted with
Civil Society as Co – Chair and with
other ministries
• All State & District TB Forum
constituted
• More than 1200 TB Champions
sensitized
• Regional Review Meetings conducted

23. Key Priorities : 2021
Inter Sectoral Coordination in TB Response ( Like COVID – 19 )
Sustaining the COVID Appropriate Behavior
Scale Up of Preventive Treatment – Household / Community / Facility level
Decentralization of TB services through HWCs
People’s Movement – “TB MUKT BHARAT”

24. Key Services
1. Free diagnosis and treatment for TB patient
2. Provision of rapid diagnostics
3. Testing of all TB patients for drug resistance and HIV
4. Management of associated diseases
5. Treatment adherence support
6. Nutrition assistance to TB patient

26. Treatment
Treatment
Patient Centric Care
Reduce Out-of-pocket
Expenditure
• Daily Regimen
• Shorter Regimen
• Newer Drugs
• IT Enabled Adherence Support
• Comorbidity management
• Direct Benefit Transfer

27. • Incentives of Rs. 1000 for notification and reporting treatment outcome will be given in two
installments (Private Practitioner)
- Rs. 500/- at notification of TB Patients
- Rs. 500/- at reporting treatment outcome
• New case : Rs. 1000 /- at completion of treatment (Government)
• Previously treated Case : Rs. 1500/- at completion of treatment
• Drug Resistance Case: Rs. 2000/- at completion of intensive phase, Rs. 3000/- at completion
of treatment
Incentives to providers

28. • Active TB Case finding in vulnerable population
• CBNAAT expansion
• Increased notification of TB Patients from private sector
• Daily regimen implementation for treatment of TB
• Universal Drug Susceptibility Testing
• Newer Drugs – Bedaquiline & Delamanid
• Direct benefit transfer scheme
• NIKSHAY Enhancement – NIKSHAY Aushadhi
Newer Initiatives

30. Bending the Curve
Accelerating towards a TB free India
Thank You …..!