Let’s count our blessings: Successes of India’s tuberculosis (TB) Programme

For a country like India that has the largest number of people infected with tuberculosis (TB) in the world, there are significant life-saving advances made in TB care and control over the past years, despite challenges. A lot more remains to be achieved but the gains made over the past decade, are commendable. Saving 2.2 million (22 lakh) lives from TB is no less achievement – for India’s national TB programme officially called the Revised National TB Control Programme (RNTCP). It is the largest TB programme in the world – more appreciated when we consider the positive side of its outcome.

“What we have achieved in the past decade in TB control, we weren’t able to achieve in the preceding 30-40 years of national TB programme” said Dr KS Sachdeva, Chief Medical Officer (CMO), Central TB Division, Government of India.

RNTCP, is run by Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, has achieved a new sputum positive TB case detection rate of more than 73% in 2010 and a treatment success rate of more than 87% against global benchmark of 70% and 85% respectively (these benchmarks were used by WHO Stop TB Strategy only till 2005). The WHO recommended treatment for TB called Directly Observed Treatment Short-course (DOTS) is now being offered to more than 1,25,000 patients each month in India, which is largest in the world in terms of patients initiated on treatment in a country.

“As we all know, TB is an infectious disease and it is very important for us to detect TB early and provide complete treatment. It is seen that most patients do not feel the need to continue the treatment as they feel better of the programme emphasizing for adherence to the treatment and keeping default rate to the minimum with the help of community DOTS provider, majority of the patients enrolled under the programme complete their treatment” said Dr Sachdeva. One wonders if RNTCP programme performance is optimal, then how come India is home to one of the highest burdens of drug-resistant TB?

UNIVERSAL ACCESS TO QUALITY TB CARE FOR ALL TB PATIENTS FROM WHICHEVER HEALTHCARE PROVIDER THEY CHOOSE TO SEEK CARE
Dr Sachdeva further informs that having achieved the global objectives of case detection and treatment success rate for last three consecutive years (these ‘global objectives’ of detecting 70% new TB cases