1. REVISED NATIONAL
TUBERCULOSIS CONTROL
PROGRAMME (RNTCP)

2. Introduction
■ TUBERCULOSIS

3. Introduction
In India everyday
More than 6000 people develop TB diseases
More than 600 people die of TB ( i.e. 2 deaths in every 5 mins )

4. NATIONALTUBERCULOSIS PROGRAM
(NTP)
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
programme (RNTCP)
■ 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

7. Objectives
■ 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.

9. Five Components of the
StopTB strategy by
World Health
Organisation

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

12. %

13. Components of ENDTB
1. INTEGRATED, PATIENT- CENTREDCARE AND PREVENTION :
diagnosis, DST,Treatment, prevention, collaboration

14. 2 BOLD POLICIES AND SUPPORTIVE
SYSTEMS
■ BOLD POLICIESAND SUPPORTIVE SYSTEMS
Political commitment
Engagement of communities, civil society organizations, and all public and private care
providers
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

18. RNTCP laboratory
network

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

21. RNTCP endorsed
diagnostic technologies for
TB & DR-TB

22. RNTCP endorsed diagnostic technologies for
TB & DR-TB
1. Sputum microscopy
2. Culture – solid, liquid
3. Rapid Diagnostic molecular
4. X ray
5. TT

23. New Initiatives
■ CBNAAT
■ NIKSHAY
■ TB notification
■ Ban on serology testing

24. ■ PMDT
■ TB and Pregnancy
■ TB HIV
■ WorldTB Day
■ BCG
■ Bedaquilline
■ Diadosine
■ Daily Regimen

25. Financial resources
Financial resources
India receives assistance from:
1.World Bank, in first phase.
2.DFID &World Bank in second phase
3.DANIDA , GDF & USAID