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Revised National Tuberculosis Control Programme: DR K S Sachdeva
Revised National Tuberculosis Control Programme: DR K S Sachdeva
Programme
Overview - Key Priorities
Dr K S Sachdeva
Deputy Director General, Central TB Division
Revised National Tuberculosis Control Programme
Ministry of Health and Family Welfare
What is Tuberculosis?
Tuberculosis (TB) is an infectious Tuberculosis generally affects the
disease caused by the bacterium lungs, but can also affect other
Mycobacterium tuberculosis parts of the body
(MTB)
Environmental
o Overcrowding
o Inadequate ventilation
o Enclosed living/working
conditions
o Occupational risks
The TB threat is REAL in India
40 crore infected
35 lakh estimated
TB patients annually
5
India: MDG6 TB target
TB EPIDEMIC REVERSED 50% DROP IN TB MORTALITY
Rate per 100,000 population 50% DROP IN TB Prevalence
35 lakh
HIV
additional
lives saved New cases All cases reduced Deaths reduced
declining
ed by half by half
v
465 195 per lakh pop
e
216 167 per lakh pop 38 17 per lakh pop
hi
(58% reduction)
(23% reduction) (55% reduction)
A c
WHO Global TB Report 2016
Sustainable Development Goals (SDG)
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)
TARGETS
INDICATORS
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
TB Free India
• India has committed to End
TB by 2025, 5 years ahead of
the global SDG target
(2017-25) Community
Engagement
Active Case
Finding
Preventive Strategi TB
Measures
es Co-morbidities
9
Ministry of Health & Family Welfare
structure
State TB Cell
36 States / UTs
District TB Centre
Supporting Facilities 733 Districts
Reaching High
patients
Active TB Sensitive
seeking care
Case Finding in Private Diagnostic
Sector tool
i
P rm
a e
O
t en
u
ti cS
•-e e
n
Treat
h
n
o
T o
ft S
r- ru
e t
C
p
ao p
e ep
• Fi
• D
n
a
n
tcn ro
cial
in
ce
n
t
ives
irectB
en
ef
itTra
n
sfer
m
kte rR
r t
e
n e
•tit C g
c o i
E m m
xC o
a ern
p
r b
e
e N
•n i
d ed
w
i ie
Direct Benefit Transfer (DBT) schemes
Existing schemes:
1. Honorarium to Treatment Supporters – For provision of
treatment support to TB patients (Adherence, ADR
monitoring, counselling @Rs.1000/- to Rs.5000/-)
2. Patient Support to Tribal TB Patients (Financial Patient
Support @Rs750/-)
New Schemes:
3. Nutritional Support to All TB patients (Financial Support to
Patients @Rs.500/-month)
4. Incentives to Private Providers (Rs.500/- for Notification &
Rs.500/- for Follow-up with Treatment Outcome @Rs. 500)
5. Incentives to Informant (Rs. 500/- is given on diagnosis of TB
among referrals from community to public sector health
facility)
Prevent
• Air borne infection control measures
• Strengthen Contact Investigation
• Preventive treatment in high risk groups
• Manage Latent TB Infection
• Address determinants of disease
Increased Access to Diagnostic
Services
Expansion of microscopy centres to improve
access
Phase 1 - PHCs where a Laboratory Technician (LT) is
available
Phase 2 – Other PHCs
Current Status – 16.1 lakh TB patients notified in
public sector (12% in 2018)
1675
Microscopy Centres in 2018
8
14,5 1 microscopy centre at ~75,000
Microscopy Centres in 2017
76 population Policy Update in RNTCP, 2018
Universal Drug Susceptibility
Testing
All TB patients to be tested for Rifampicin Resistance
Current Status – 60% of target
DR-TB patients diagnosed
(54% from 2017)
• All • MDR/RR-
MDR/RR- TB
TB patients
patients with
without resistance
resistant to addl.
to addl. SLD &
SLD eligible
Injection Free
(3-6) Km Lfx R E Z regimen for Lfx R E Z
~1,00,000
patients Policy Update in RNTCP, 2018
Gazette on TB Notification
48 Cities in JEET & others
90 Cities approved in PIP
Mandatory Notification of TB
patients
Provider
Influence Provider
Notification
Public Health Actions
RNTCP Linkage
Provisions of Sections 269 and 270 of the
Indian Penal Code (IPC)
Treatment Support
Notices
Patient
Policy Update in RNTCP, 2018
1 519
Multi-sectoral Engagement
TB care services in Socio-economic
health support &
infrastructure Empowerment
Infection
Prevention Information
Education
Address Communication
Determinants
e
n
Community Engagement
t
s 2
Transformation of TB survivors to
| 3 2 TB champions
5
C 1 S Capacity building and mentoring
o t programme
m
m D a Engagement of existing
u
n i t community groups like PRI, SHG,
s e VHSNC, MAS, Youth Club
t t s Grievance redressal mechanism
y
4 r Involvement of community
i representatives in different
a
c forums
k t
h s
Call Centre
1800-11-6666 Nikshay Counsel
Poshan
Outbound & Inbound Yojana ling
Time – 7 to 11 Treatm
Informa ent
Languages – 14 tion Adhere
nce
100 call centre agents
TB
Pan-India coverage Notifica Grievance
Redressal
tion
Citizen – Patient - Providers Follow
Up
Policy Update in RNTCP, 2018
Subnational Certification for
TB Free District / State
Accelerate efforts
TB
Contextual strategies Free
State
Award State/Uts with State/Uts with State/Uts with Non-Monetary
Categories population <50 lakh population 50 lakh – population >5 Cr Recognition
5 Cr
Bronze 10 lakhs 15 lakhs 25 lakhs Certification and
Felicitation at
Silver 20 lakhs 35 lakhs 50 lakhs the National
Gold 40 lakhs 60 lakhs 75 lakhs Level
TB Free Status 60 lakhs 75 lakhs 1 Crore
State TB Index
3. Drug Resistant TB
5. Undernutrition, overcrowding