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NRHM approaches Maha FDA to identify pharmacies to offer treatment to TB patients not covered under DOTS

Shardul Nautiyal, Mumbai
Monday, February 12, 2018, 08:00 Hrs  [IST]

In order to check the prevalence of TB in individuals who are not covered under Directly Observed Treatment, Short-Course (DOTS), the National Rural Health Mission (NRHM) has approached the Maharashtra FDA to identify pharmacies across the state. These designated pharmacies will stock medicines for TB patients not reported and covered under the government’s programme.

India has the highest tuberculosis burden in the world, accounting for nearly one-fourth of the global incidence. Experts advocate that there is a need to have epidemiological data on TB through a nationwide surveillance as was done in China a few years ago.

Says Maharashtra FDA Commissioner Dr Pallavi Darade, “We are in talks with NRHM on starting the initiative with their support in the interest of patients who are neither covered under DOTS nor availing therapeutic intervention offered by the government under the Revised National Tuberculosis Programme (RNTCP).”

The large scale implementation of the government’s RNTCP (earlier known as RNTCP-I) was started in 1997. The RNTCP was then expanded across India until the entire nation was covered by the RNTCP in March 2006. At this time the RNTCP also became known as RNTCP II. RNTCP II was designed to consolidate the gains achieved in RNTCP I, and to initiate services to address TB or HIV, MDR-TB and to extend RNTCP to the private sector.

RNTCP uses the World Health Organisation (WHO) recommended DOTS strategy and reaches over a billion people in 632 districts or reporting units. The RNTCP is responsible for carrying out the Government of India's five year TB National Strategic Plans.  With the RNTCP both diagnosis and treatment of TB are free. There is also, at least in theory, no waiting period for patients seeking treatment and TB drugs.

In India, death rates have also increased over the past several decades despite the official data showing 100 per cent coverage of DOTS programme in the country.

Official estimates show emergence of only 3 per cent new MDR TB cases and 17 per cent re-treatment cases based on the figures extrapolated from very few good centres working on TB control which is not representative.

Implementation research projects using more sensitive diagnostics like Genexpert has also been upscaled to pick up TB and MDR TB in children. Now there is also a thrust upon designing treatment regimens to offer optimal and shorter dosages for children suffering from TB.

According to data available with RNTCP, there were 53 MDR-TB patients in 2012 which rose to 5,000 in 2014. Also in case of XDR TB, there were 32 patients in 2012 which increased to 240 in 2014. In 2012, out of the estimated global annual incidence of 8.7 million TB cases, 2 to 2.4 million were estimated to have occurred in India.


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