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National Tuberculosis Programme (NTP) has been in operation since 1962. Its objectives are:
1. Long term objective – to reduce tuberculosis in the community to that level when it ceases to be a public health problem, i.e.
a. One case infects less than one new person annually;
b. The prevalence of infection in age group below 14 years is brought down to less than 1 percent, against about 30 percent as at present.
2. Operation or short term objectives:
1. To detect maximum number of TB cases among the outpatients attending any health institution with symptoms suggestive of tuberculosis and treat them effectively;
2. To vaccinate newborns and infants with BCG;
3. To undertake the above objectives in an integrated manner through all the existing health institutions in the country.
NTP operates through the District Tuberculosis Programme (DTP) which is the backbone of the NTP. Over 600 TB clinics have been set up in the country, of which 390 have been upgraded to date as District TB Centres (DTC) to undertake district-wise TB control in association with general health and medical institutions. It was evolved by the National Tuberculosis Institute, Bangalore, and was accepted by the Government of India for implementation in 1962. District Tuberculosis Centre (DTC) is the nucleus of the DTP. The function of DTC is to plan, organise and implement the DTP in the entire district, in association with general health services. 390 DTCs were functioning in the country in 1999. The health institutions available for inclusion in DTP are Government general hospitals and community health centres, primary health centres, tuberculosis clinics other than DTC and outpatient departments of tuberculosis sanatoria and hospitals (TBC), other health institutions like dispensaries, health units, hospitals including those managed by t he government health schemes (e.g. CGHS, Railways, etc.) Employees State Insurance Scheme, Local bodies, religious missions, voluntary organisation and private charitable societies.
The activities of DTC include:
1. Case finding
2. Treatment
3. BCG vaccination
4. Recording and reporting
5. Supervision
The National Tuberculosis Control Programme has been accorded high priority by the government. With the inclusion of NTP in t he 20 point programmes, there is expansion of essential activities under the programme. There has been considerable increase in budget allotment. The international agencies like WHO, SIDA, DANIDA, World Bank etc. are providing the assistance to NTP.
The Government of India, WHO and World Bank together reviewed the NTP in the year 1992. Based on the findings a revised strategy for NTP was evolved.
1. Achievement of at least 85% cure rate of tuberculosis patient through the involvement of DOTS therapy on peripheral health institutions.
2. Bringing the fastness in case finding and diagnosis identified at least 75% of the case through qualitative microscopic examination.
3. Motivation of active participation of non-governmental organizations, improvement in the IEC system, and promotion of research in this area.
4. Ensuring the examination of anti-tubercular drugs and microscopes used in this programme.
5. Strengthen operational tuberculosis control centres in central and states and establishment of appropriate supervision units for tuberculosis control.
In 2006 STOP–TB Strategy was announced by WHO and adopted by RNTCP. It has the following components:
1. Pursuing quality DOTS –expansion and enhancement.
2. Addressing TB/ HIV and MDR–TB.
3. Contributing to health system strengthening.
4. Engaging all care providers.
5. Empowering patients and communities.
6. Enabling and promoting research (diagnosis, treatment, and research)
1. Early diagnosis of TB including universal drug susceptibility testing and systemic screening of contacts and high risk groups
2. Treatment of all people with Tb including drug resistant TB and patient support
3. Preventive treatment of persons at high risk and vaccination against TB
4. Collaborative TB and HIV management
This pillar requires intense participation across government, communities, and private stakeholders.
1. Strengthens health and social sector policies and systems to prevent and end TB.
2. Supports implementation of universal health coverage, social protection and strengthens regulatory frameworks.
3. Addresses the social determinants of TB and tackles TB among vulnerable groups such as very poor people living with HIV, migrants, refugees, and prisoners
This pillar of research is critical to break the trajectory of the epidemic and reach global targets.
1. Aims to intensify research by the development of new tools to their adoption and effective roll-out in countries
2. Pursue operational research for the design, implementation, and scaling-up of innovations
3. Calls for an urgent boost in research investments so that new tools are developed and made rapidly available and widely accessible in the next decade
Getting to the 2025 targets requires effective use of existing tools to combat TB, complemented by universal health coverage and social protection.
1. Push down global TB incidence rates from an annual decline of 2% in 2015 to 10% by 2025.
2. Reduce the proportion of people with TB who die from the disease from 15% in 2015 to 5% by 2025.
Moving forward to the 2035 targets requires the ensured availability of new tools from the research pipeline, in particular.
1. Better diagnostics, including new point-of-care tests;
2. Safer, easier and shorter treatment regimens;
3. Safer and more effective treatment for latent TB infection;
4. Effective pre-and post-exposure vaccines
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