Prime Minister Narendra Modi has written to all chief ministers, asking them address the challenge of tuberculosis in a mission mode and review the progress of the Revised National Tuberculosis Control Programme (RNTCP) at least every quarter.
 

He urged them to closely monitor key performance indicators such as case notification (including from private sector), treatment success rate and active case finding. He said tuberculosis is the biggest killer among all infectious diseases and about 29 lakh new TB cases are reported every year. About 4.20 lakh people, mostly poor, die annually due to tuberculosis, leaving lakhs of children orphaned. Economic loss on account of TB in India is about Rs. 20,000 crore per annum, Modi wrote in the letter.

"We cannot allow such human tragedies, for a disease which is treatable and for which drugs and diagnostics are available in the public health care system," the letter read. The PM wrote the government was committed to eliminating TB, five years ahead of the Sustainable Development Goals for which the health ministry was implementing the RNTCP with "new vigour".

The RNTCP has taken several new initiatives like daily regimen, universal drug susceptibility testing, active case finding in vulnerable groups and cross reference between HIV and TB cases to help us address the challenge posed by TB, he wrote. "It is incumbent upon us to address this challenge in a mission mode. I request you to kindly reveiw the progress of the programme at least every quarter and closely monitor key performance indicators like case notification (including from private sector), treatment success rate, active case finding and HR vacancy," he said.

The government is planning to give Rs. 500 a month to tuberculosis patients, irrespective of their income level, to help them buy nutritious food and compensate them for travel expenses until they are cured. The Expenditure Finance Committee has approved the proposal and sent it to the Mission Steering Group, a health ministry official had said earlier. The ministry recently rolled out the daily drug regimen to combat the disease across the country.

Under the new treatment policy, patients are given fixed drug combinations - three or four drugs in a single pill - daily, instead of thrice a week (intermittent drug regimen). Dosage is determined according to the patient's body weight. Previously, it was same for all adults. Also, children suffering from tuberculosis won't have to take the bitter tablets anymore as they will be replaced with easily-dissoluble and flavoured drugs.

Since 1997, under the RNTCP, patients were being administered drugs thrice a week. The daily treatment regimen is likely to be more effective with lesser relapses and it is expected to reduce drug-resistance with greater compliance. The WHO revised its TB management guidelines in 2010, recommending that the daily drug regimen be adopted under the RNTCP.