India is the highest TB burden country accounting for the fifth (21%) of the global incidence (Global annual incidence estimate is 4.5 million cases out of which it is estimated that 2 million cases are from India). India is 17th among 22 High Burden Countries in terms of TB incicdence rate. (Source: WHO global TB report 2010).
The Revised National TB Control Programme (RNTCP), based on the internationally recommended Directly Observed Treatment Short-course (DOTS) strategy, was launched in 1997 expanded across the country in a phased manner with support from the World Bank and other development partners.
The objectives of the programmed are to
a) To achieve and maintain cure rate of at least 85% among New Sputum Positive (NSP) cases in the community.
b) To achieve and maintain case detection of at least 70% of the estimated NSP cases in the community.
Current focus of the programme is on ensuring “universal access” to good quality early diagnosis and treatment for all TB patients from which ever provider they choose to seek care.
The program is coverting the entire nation since March 2006 reaching over a billion population (1164 million) in 632 districts/reporting units. In 2008, 1.51 million patients wee put on treatment and in 2009, 1.53 million patients and in 2010, 1.52 million patients have already been placed on treatment.
Since its inception, the Programme has initiated more than 12.8 million patients on treatment, thus saving nearly 2.3 million additional lives.
Since 2007 programme is achieving a treatment success rate of >85% asn had consistently maintained the NSP case detection rate (CDR) of >70%. In 2010, RNTCP has achieved the NSP CDR of 71% and treatment success rate of 87% which is in live with the global targets for TB control.
Monitoring, supervision and evaluation: All states are currently implementing the ‘Supervision and Monitoring strategy’ - detailing guidelines, tools and indicators for monitoring the performance from the PHI level to the national level. The quality program implementation is ensured by frequent internal and external evaluations. The program is focusing on the reduction in the default rates among all new and retreatment cases and is undertaking steps for the same.
Qualit assured sputum smear microscopy facilities are available through more than 13000 sputum microscopy laboratries in the health sstem across the country. As a result, the suspect’s examination has increased substantially from 397 per 100000 population per annum to 642 per 100000 population over thelast 10 years, reaching out to the population.
Quality assured, anti-TB drugs for the full course of treatment is provided to the patients through patient wise boxes. Decentralized treatment is provided through a network of more than