4. NATIONALTUBERCULOSIS PROGRAM
o Operational since 1962.
o Unacceptably low success rate.
o Spread of multidrug resistant TB.
o Managerial weakness
o Inadequate funding.
o Over-reliance of X-ray for diagnosis.
o Frequent interrupted supplies of drugs.
o Low rate of treatment completion.
5. Evolution ofTB Control in India
■ 1950s-60s ImportantTB research atTRC and NTI
■ 1962 NationalTB Programme (NTP)
■ 1992 Programme Review
only 30% of patients diagnosed;
of these, only 30% treated successfully
■ 1993 RNTCP pilot began
■ 1998 RNTCP scale-up
■ 2006 Entire country covered
6. Revised national tuberculosis control
■ Launched in 1997 based onWHO DOTS Strategy
■ ◦ Entire country covered in March’06 through an unprecedented rapid expansion of
DOTS Implemented as 100% centrally sponsored program
■ ◦ Govt. of India is committed to continue the support tillTB ceases to be a public
health problem in the country
■ All components of the STOPTB Strategy-2006 are being implemented
■ Achievement of at least 85% cure rate of infectious cases; through DOTS involving
peripheral health functionaries.
■ Augmentation of case finding activities through quality sputum microscopy to detect
at least 70% of estimated cases.
8. Directly ObservedTreatment, Short Course,
comprises five components
1. Sustained political and financial commitment
2. Diagnosis by quality ensured sputum-smear microscopy.
3. Standardized short-course anti-TB treatment (SCC)
4. A regular, uninterrupted supply of high quality anti-TB drugs
5. Standardized recording and reporting.
10. StopTB strategy
1. Pursue high-quality DOTS expansion and enhancement.
2. AddressTB-HIV, MDR-TB, and the needs of poor and vulnerable populations
3. Contribute to health system strengthening based on primary health care
4. Engage all care providers
5. Empower people withTB, and communities through partnership.
6. Enable and promote research
13. Components of ENDTB
1. INTEGRATED, PATIENT- CENTREDCARE AND PREVENTION :
diagnosis, DST,Treatment, prevention, collaboration
14. 2 BOLD POLICIES AND SUPPORTIVE
■ BOLD POLICIESAND SUPPORTIVE SYSTEMS
Engagement of communities, civil society organizations, and all public and private care
Universal health coverage policy, and regulatory frameworks for case notification, vital
registration, quality and rational use of medicines, and infection control
Social protection, poverty alleviation and actions on other determinants ofTB
15. 3.INTENSIFIED RESEARCH AND INNOVATION
■ Discovery, development and rapid uptake of new tools, interventions and strategies
■ Research to optimize implementation and impact; and promote innovations
19. ■ RNTCP has quality assured laboratory network for bacteriological examination of
sputum in a three tier system consisting of
■ ◦ Designated MicroscopyCentre (DMC),
◦ Intermediate Reference laboratory (IRL),
■ ◦ National Reference laboratory (NRL).
20. ■ RNTCP External QualityAssessment
■ o Panel testing
o On‐site evaluation
o Random blinded rechecking of routine slides