National Tuberculosis Elimination Programme.pptx

RNTCP is renamed as a NTEP (National Tuberculosis Control Programme) --> to reach the SDG target of TB Elimination

1. National Tuberculosis Elimination Programme (NTEP) Facilitator : Dr.Manisha Gohel Presenter: Dr.Darshna Sarvaiya , Third Year Resident Department of Community Medicine

2. To describe magnitude of TB Problem To explain evolution of TB Control Strategies in India To enlist goals, objectives of NTEP To summarize newer initiatives under NTEP Objectives

3. Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis (MTB) Tuberculosis generally affects the lungs , but can also affect other parts of the body One patient with infectious pulmonary TB if untreated can infect 10-15 persons in a year What is Tuberculosis ?

4. Malnutrition Diabetes HIV infection Low body weight Severe kidney disease Other lung diseases (silicosis) Substance abuse etc. Overcrowding Inadequate ventilation Enclosed living/working conditions Occupational risks Environmental Medical Risk Factors

5. India is the highest TB burden country India - 26% Indonesia – 10% China – 10% Nigeria – 06% South Africa – 04% Pakistan – 03% Total 60% global burden of TB disease lies within 6 countries TB High Burden Countries

6. The TB threat is REAL in India 10 million people fell ill from TB 1.4 million people died from TB 4.6 lakh people had drug-resistant TB Missing million TB patients 1 patient dies every minute Less than 50% treated successfully WHO Global TB Report 2020

7. TB Notification Progress under NTEP WHO Global TB Report 2020

8. The India’s Tuberculosis (TB) control programme got rechristened to National Tuberculosis Elimination Programme (NTEP) from Revised National Tuberculosis Control programme Programme (RNTCP) on 1 st January , 2020 Transition from RNTCP  NTEP

9. India has committed to end TB by 2025, 5 year ahead of the global SDG target Prime Minister of India launched TB free India campaign at “Delhi End TB Summit” on 13 th March, 2018 The campaign calls for a social movement focused on patient – centric and holistic care driven by integrated actions for TB free India TB Free India Campaign

10. To reduce mortality and morbidity From TB To interrupt chain of transmission until TB ceases to be a public health problem in India Goals

11. To reduce incidence of TB and mortality due to TB To prevent emergence of drug resistance and effectively manage drug – resistance TB To improve outcomes among HIV – infected TB Patients To decentralize and align RNTCP management units with NHM block level units within general health system Objectives – to achieve TB Free India

12. India: MDG6 TB target TB EPIDEMIC REVERSED Rate per 100,000 population 50% DROP IN TB MORTALITY 35 lakh additional lives saved 50% DROP IN TB Prevalence New cases declining All cases reduced by half Deaths reduced by half HIV WHO Global TB Report 2016 465  195 per lakh pop ( 58% reduction) 38  17 per lakh pop ( 55% reduction) 216  167 per lakh pop ( 23% reduction) Achieved

13. 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

14. TB Elimination

15. Infrastructure Scale Up TB Microscopy Centre Molecular Testing Lab Financial Allocation

16. Mitigation Measures during the pandemic Directives for uninterrupted TB Services Bi – directional TB – COVID Screening Telemedicine and Active Case Findings (ACF) Scale up of Platform technologies PPEs for staff & door – step sample collection and delievery of drugs Timely release of benefits under Nikshay Poshan Yojana E – trainings and periodic review with States / Districts at all levels Achievements – 2020 HIV Status known: 92% UDST Offered: 67 % Treatment Success Rate : 82% DR TB Treatment Initiation : 86% Nikshay Poshan Yojana Paid : 62%

17. Strengthening Case Findings Population Levels Screening followed by Active Case Finding among Vulnerable & comorbid Extrapulmonary diagnosis Medical College involvement Decentralizing TB Services to HWCs Intensified Case Findings in other OPDs like NCD / HIV Mandatory Notification – Gazette Schedule H 1 Surveillance Incentives for providers and informants Public Private

18. TB MUKT BHARAT January Active Case Findings February Orienting Elected Representatives on TB March World TB Day April Engaging Communities through – HWCs May TB Free Workplaces June TB & Women July Engaging Religious Leaders & PRIs August TB Prevention & Lung Health September TB & Nutrition October Engaging Children & Youth November TB Camps December Stigma Mitigation

19. Subnational Certification of TB Free Status

20. Subnational Certification Awards – 2020

21. Community Engagement National TB Forum Constituted with Civil Society as Co – Chair and with other ministries All State & District TB Forum constituted More than 1200 TB Champions sensitized Regional Review Meetings conducted

22. Key Priorities : 2021

23. Key Services Free diagnosis and treatment for TB patient Provision of rapid diagnostics Testing of all TB patients for drug resistance and HIV Management of associated diseases Treatment adherence support Nutrition assistance to TB patient

24. Treatment

25. Incentives of Rs. 1000 for notification and reporting treatment outcome will be given in two installments (Private Practitioner) - Rs. 500/- at notification of TB Patients - Rs. 500/- at reporting treatment outcome New case : Rs. 1000 /- at completion of treatment (Government) Previously treated Case : Rs. 1500/- at completion of treatment Drug Resistance Case: Rs. 2000/- at completion of intensive phase, Rs. 3000/- at completion of treatment Incentives to providers

26. Active TB Case finding in vulnerable population CBNAAT expansion Increased notification of TB Patients from private sector Daily regimen implementation for treatment of TB Universal Drug Susceptibility Testing Newer Drugs – Bedaquiline & Delamanid Direct benefit transfer scheme NIKSHAY Enhancement – NIKSHAY Aushadhi Newer Initiatives

27. Bending the Curve Accelerating towards a TB free India Thank You …..!