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T.B.
(TUBERCULOSIS)
BURDEN IN
INDIA
Presented By:- Sahdev

Definition
 Tuberculosis(TB) is a potentially fatal contagious disease
that can affect almost any part of the body but is an mainly
infection of the lungs. It is caused by mycobacterium
tuberculosis.
 Tubercule – Round nodule/swelling
Osis – condition
 Tuberculosis (TB) control activities are implemented in the
country for more than 50 years. The National TB
Programme (NTP) was launched by the Government of
India in 1962 in the form of District TB Centre model
involved with BCG vaccination and TB treatment. In 1978,
BCG vaccination was shifted under the Expanded
Programme on Immunization.

DOTS
Around the same time in1993, the WHO declared
TB as a global emergency, devised the directly
observed treatment – short course (DOTS), and
recommended to follow it by all countries. The
Government of India revitalized NTP as Revised
National TB Control Programme (RNTCP) in the
same year. DOTS was officially launched as the
RNTCP strategy in 1997 and by the end of 2005
the entire country was covered under the
programme.

Nikshay
NIKSHAY:- To facilitate TB notification, RNTCP
has developed a case-based web-based TB
surveillance system called “NIKSHAY”
(https://nikshay.gov.in ) for both government
and private health care facilities. Future
enhancements under NIKSHAY are for patients
support, logistics management, direct data
transfers, adherence support and to support
interface agencies which are supporting
programme to expand the reach.

Nikshay Poshak Yojna
It is centrally sponsored scheme under
National Health Mission (NHM), financial
incentive of Rs.500/- per month is provided
for nutritional support to each notified TB
patient for duration for which the patient is on
anti-TB treatment. Incentives are delivered
through Direct benefit transfer (DBT) scheme
to bank accounts of beneficiary*.

Second Phase 2006-11
During 2006–11, in its second phase RNTCP improved
the quality and reach of services, and worked to reach
global case detection and cure targets. TB was the
leading cause of illness and death among persons living
with HIV/AIDS and large number of multidrug resistant
TB (MDR-TB) cases were reported every year. During
this period for achievement of the long term vision of a
“TB free India”, National Strategic Plan for Tuberculosis
Control 2012-2017 was documented with the goal of
‘universal access to quality TB diagnosis and treatment
for all TB patients in the community’.

Plan for 2012-2017
Significant interventions and initiatives were
taken during NSP 2012-2017 in terms of
mandatory notification of all TB cases, integration
of the programme with the general health
services (National Health Mission), expansion of
diagnostics services, programmatic management
of drug resistant TB (PMDT) service expansion,
single window service for TB-HIV cases, national
drug resistance surveillance and revision of
partnership guidelines.

National strategic plan for tuberculosis
elimination 2017-2025
• RNTCP has released a ‘National strategic plan
for tuberculosis 2017-2025’ (NSP) for the
control and elimination of TB in India by 2025.
According to the NSP TB elimination have
been integrated into the four strategic pillars
of “Detect – Treat – Prevent – Build” (DTPB).

PPP
 Public private partnership:- For promotion of public-private mix
(PPM) in TB prevention and care, private providers are provided
incentives for TB case notification, and for ensuring treatment
adherence and treatment completion. The incentives are provided
through direct beneficiary transfer.
 The incentives to the Private Sector TB Care Provider are as
follows:
 Rs 250/- on notification of a TB case diagnosed as per Standards for
TB Care in India (STCI).
 Rs 250/- on completion of every month of treatment.
 Rs 500/- on completion of entire course of TB treatment.
 Rs 2750/ for notification and management of a drug-sensitive
patient over 6-9 months as per STCI.
 Rs 6750/-for notification and correct management of a drug-
resistant case over 24 months as per STCI.

Free drugs and diagnostic tests to TB
patients in private sector
• Free drugs and diagnostic tests are provided
to TB patients seeking treatment from private
health sector. There are two approaches for
ensuring access to free drugs and diagnostic
tests to TB patients in private sector, first is
access to programme- provided drugs and
diagnostics through attractive linkages; and
second is reimbursement of market- available
drugs and diagnostics.

TB Elimination by 2025
• However, to eliminate TB in India by 2025, five
years ahead of the global target, a framework to
guide the activities of all stakeholders including
the national and state governments,
development partners, civil society organizations,
international agencies, research institutions,
private sector, and many others whose work is
relevant to TB elimination in India is formulated
by RNTCP as National Strategic Plan for
Tuberculosis Elimination 2017-2025.

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Prevention
Air borne infection control measures
Contact tracing
Isoniazid Preventive Therapy (IPT)
BCG vaccination
Addressing social determinants of TB like poverty,
malnutrition, urbanization, indoor air pollution, etc.
Build:- the form of building and strengthening enabling
policies, empowering institutions and human resources
with enhanced capacities.
BCC & IEC

Organisation Structure of RNTCP

Bibliography
https://www.nhp.gov.in/revised-national-
tuberculosis-control-programme.
https://tbcindia.gov.in/showfile.php?lid=3322
https://tbcindia.gov.in/WriteReadData/NSP%2
0Draft%2020.02.2017%201.pdf.

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