National Tuberculosis Elimination Programme

1. Overview – Key Priorities
Dr. IMMANUEL JOSHUA
Junior Resident-II
Dept. of Community Medicine
Banaras Hindu University
Varanasi-221005

2. 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)
Sustainable Development Goals (SDG)
INDICATORS
TARGETS
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

3. Catastrophic
Expenditure

4. TB type Treatment duration Cost per patient
Drug Sensitive TB 6-8 months Rs 2100
Drug Resistant TB 9-11/ 18-20 months Rs 9768-119617

6. TB Free India
• India has committed to End TB by 2025, 5 years ahead of
the global SDG target
• Prime Minister of India launched TB Free India campaign
at ‘Delhi End TB Summit’ on 13th March, 2018
• The campaign calls for a social movement focused on
patient-centric and holistic care driven by integrated
actions for TB Free India

7. 1962
1997
2005-11
2012-17
2020
NTEP
EVOLUTION
2017-25
Govt. of India launched the
National TB Program and
set up District TB Centres
GoI revised NTP to RNTCP
– introduction of DOTS
Second phase of
RNTCP – Pan India
coverage and
improved quality and
scale up of services
National Strategic Plan (2012 -17) -
mandatory notification of TB, rapid
molecular testing, active case finding
and integration of the program with
National Health Mission
In January 2020, GoI revised RNTCP to
National TB Elimination Program (NTEP)
NSP (2017 – 25) –
patient centric care
for TB elimination
2021
TB Mukt Bharat Abhiyaan

8. Treat
Prevent
Build
Detect
National Strategic Plan (2017-2025)
Find all TB cases with an emphasis on reaching every
TB patient in the private sector
Treat all TB cases with high quality anti TB drugs
Prevent the emergence of TB in susceptible
populations and stop catastrophic expenditure
Build & strengthen supportive systems including
enabling policies, empowered institutions & human
resources

9. Scale up molecular
diagnostics to the
peripheral levels
Decentralize TB
screening to AB-
HWC levels
Early detection of
DRTB Universal DST
Vulnerability mapping &
Active case finding
Private sector
engagement
DETECT

10. Daily regimen
–Fixed Dose
Combination
Injection free
treatment regimens
Scale up of Newer
drugs/regimens
TREAT
Sustain treatment
success rate of
>90%

11. Contact Tracing &
TB Preventive
Treatment
Sustaining COVID
appropriate
behavior
Airborne Infection
Control in community &
Health Facilities
Community
Mobilization &
People’s Movement
PREVENT

12. B
U
I
L
D
Procurement and Supply Chain
management
IEC
Digital Interventions
Human Resources Development
Surveillance
Multisectoral Collaboration
Capacity Building

13. TB DISEASE
 Untreated TB case can transmit disease
to at least 10-15 people in a year
 Contacts of an active case are at 10 to
60 times higher risk of developing the
disease

15. Treatment
Regimens

16. TB Preventive treatment (TPT)

18. Public Health Action at Health Facility Level
Mandatory action at Health Facility Level

19. Mandatory action at community level

20. Connecting patients /
citizens with NTEP

22. Call Centre- Nikshay Sampark
1800-11-6666
 Outbound & Inbound
 Time – 7am to 11pm
 Languages – 14
 100 call centre agents
 Pan-India coverage
 Citizen – Patient - Providers
Counselling
Treatment
Adherence
Grievance
Redressal
Follow
Up
TB
Notification
Information
Nikshay
Poshan
Yojana

23. 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/-)
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 reporting of
Treatment Outcome
5. Incentives to Informant (Rs.500/- is given on diagnosis of TB among referrals from
community to public sector health facility)
Direct Benefit Transfer (DBT) schemes

24. Community Engagement
Transformation of TB survivors to TB champions
Capacity building and mentoring programme
Grievance redressal mechanism
Involvement of community representatives in different forums
Engagement of existing community groups like PRI, SHG, VHSNC, MAS, Youth Club

26. MoHFW invites
Claims
Districts submit
claims to State
States submit
claims to
MoHFW
Independent
Agency (ICMR)
verifies claims
Successful
claims awarded
on World TB Day
August 31 March 24
Sub National TB Free Certification
• Community survey to find out incidence & under-reporting
• Interviews & FGDs with private doctors & chemists to verify drug sale
• Review of records & patient interviews to verify TB score
VERIFICATION

27. Subnational certification of Sonbhadra District

29. Sub-National Disease Certification
Award Decline in incidence
rate compared to
2015
Monetary Award
for District (in Rs.)
Bronze 20% 2 lakhs
Silver 40% 3 lakhs
Gold 60% 5 lakhs
TB Free Status 80% 10 lakhs
District

30. State
Award State/Uts
with pop.
<50 lakh
State/Uts
(pop. 50 lakh
– 5 Cr
State/Uts
pop.>5 Cr
Bronze 10 lakhs 15 lakhs 25 lakhs
Silver 20 lakhs 35 lakhs 50 lakhs
Gold 40 lakhs 60 lakhs 75 lakhs
TB Free 60 lakhs 75 lakhs 1 Crore

31. Policy Update in RNTCP, 2018
State TB Index

32. -Diagnosis and treatment
through Railway
hospitals/ dispensaries
-Mapping of Railway Health
Facilities in Nikshay
-Use of NTEP IEC Material
in Railway premises
-Support towards upgradation of health
infrastructure using MoTA funds
-Involvement of NGOs under MoTA in TB
-Joint Tribal Action Plan for TB in notified Tribal
districts
- TB Free Workplace policy
-Diagnosis and treatment
through ESIC hospitals/
dispensaries
-Network of Training Institutes
under MoLE to reach out to
work places
Proposed Committee under HFM with Ministers of Prioritized Ministries- Sep/Oct 2021
Railways
Tribal
Affairs
Labour
&
Empl.
Inter Ministerial Collaboration
6 MoUs signed with Railways, Defence, AYUSH, Labour & Employment, CII and DONER

33. The Corporate TB Pledge (CTP) program is a joint initiative of the Central TB Division,
Ministry of Health and Family Welfare, Government of India and USAID in collaboration with
The International Union Against Tuberculosis and Lung Diseases, with the objective to
develop a shared vision, in alignment with vision of eliminating TB in India by 2025.

34. The Corporate TB Pledge program was launched in April 2019 and offers a tiered
approach for corporates to use their resources (human and financial), to combat TB, raise
awareness of TB as a curable disease, and ultimately improve TB health outcomes

35. WORLD TB DAY-2022

36. THANK YOU