Author(s): Central TB Division
India is the highest TB burden country accounting for one fifth of the global incidence (Global annual incidence estimate is 9.4 million cases out of which it is estimated that 1.98 million cases are from India). India is 17th among 22 High Burden Countries in terms of TB incidence rate (Source: WHO global TB report 2009). 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. Full nation wide coverage was achieved in March 2006 covering over a billion populations (1164 million) in 632 districts/reporting units. In terms of treatment of patients, RNTCP is the largest and the fastest expanding programme in the world. In 2005, 1.29 million TB patients, in 2006, 1.39 million and in 2007,1.48 million patients have been enrolled for treatment. In 2008 1.51 million patients were put on treatment and in 2009 1.53 million patients have been placed on treatment. Treatment success rates have tripled from 25% to 87% & TB death rates have been cut 7-fold from 29% to less than 5% in comparison to the pre-RNTCP era. Since its inception, the Programme has initiated more than 11 million patients on treatment, thus saving more than 2 million additional lives. The programme has consistently maintained the treatment success rate >85% and NSP case detection rate (CDR) close to the global target of 70%. In 2009, RNTCP has achieved the NSP CDR of 72% and treatment success rate of 87% which is in line 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 programme is focusing on the reduction in the default rates amongst all new and re-treatment cases and is undertaking steps for the same. Quality assured sputum smear microscopy facilities are available through more than 12,500 sputum microscopy laboratories in the health system across the country. As a result, the proportions of sputum positive cases confirmed in the laboratory are double to that of the previous programme and are on par with international standards.