2. TB statistics in India
■ India is the highest TB burden country
■ Accounts for 1/5th (21%) of the global
incidence of TB
■ WHO statistics for 2014 –
Incidence figure of 2.2 million
cases of TB for India out of a global
incidence of 9 million.
Prevalence figure 2.5 million
3. Every day in India
nearly 1,000 deaths due to TB
Two people die in every three minutes
4. History of TB control in India
■ 1900 - First open-air sanatorium for treatment and
isolation of TB patients founded in 1906 in Tiluania ,
near Ajmer and two years later one was opened in
Almora
■ 1940 -1960 - anti TB drugs like streptomycin, INH,PAS
■ 1948 – work with BCG started as pilot project ; 1949
extended to cover schools in almost all states.
■ 1962 - National TB Control Programme (NTP)
■ 1993 - RNTCP pilot project
5.
6. NTP - National TB Control Programme
■ Based on research in the 1950s and early 1960s by the
TRC at Chennai and the NTI at Bangalore, a National
Tuberculosis Programme (NTP) was implemented by
Government of India in 1962.
7. WHY DID NTP FAIL?
■ Inadequate budget and lack of political commitment
■ Shortage of drugs
■ Low rates of treatment completion
Only 30% patients diagnosed
Of these only 30% treated successfully
■ Emphasis on x-ray diagnosis resulting in false
diagnosis
■ Inadequate microbiology labs leading to unreliable
sputum microscopy
8. RNTCP
■ RNTCP based on the WHO recommended DOTS strategy
was launched in 1993 as pilot project
■ RNTCP: 1997 launched as national programme
■ By end of 1998 only 2% of total Indian population was
covered. Since March 2006 ,it covers the whole country
9. Objectives
■ To achieve and maintain cure rate of at least 85% among
New Sputum Positive (NSP) patients.
■ To achieve and maintain case detection of at least 70% of
the estimated NSP cases in the community.
10. • Political will and Administrative commitment
• Diagnosis by quality assured sputum smear microscopy
• Adequate supply of quality assured short course
chemotherapy drugs
• Directly observed treatment
• Systemic monitoring and accountability
11. WEAKNESS
In 2014 Joint TB Monitoring mission (JMM) report
■ Additional funding
■ Use of a thrice weekly intermittent regimen and starting
treatment without knowing the resistance profile of the patients
contributes to the amplification of resistance.
■ Delays in supply chain management, bad storage conditions of
drugs continue to be a problem
■ Integration of HIV-TB departments is still very slow.
■ The lack of engagement of RNTCP with the massive private
sector
■ Actual implementation of the policy revisions in RNTCP is not
being done
