core sector communique

GOI-WHO Joint Monitoring Mission endorses the National Strategic Plan - Lauds Government’s TB control efforts; calls for overcoming challenges to universal access

The fifth Government of India-WHO Joint Monitoring Mission (JMM) of the Revised National Tuberculosis Control Programme (RNTCP), Government of India, has endorsed the National Strategic Plan (NSP) for TB Control (2012-2017). The NSP has set the goal of universal access to early diagnosis and effective treatment.   The JMM has also lauded the government on its efforts in TB control. However, the JMM cautioned that successful implementation requires an urgent and emphatic expansion in the prioritization, development, financing and deployment of innovative activities to rapidly detect and correctly treat TB cases irrespective of care in public or private sectors. Endorsing the NSP, the JMM has also concurred with the government view that if implemented properly, it can save 750,000 lives over the next five years and transform TB control in India. To achieve the ambitious goals set-out in the NSP, the JMM has recommended that the RNTCP prioritize engagement of the private sector, strengthen supervision systems, extend case-finding to the community level, and support innovation at all levels. Some of the JMM key recommendations include: Engage all care providers to achieve universal access to TB care and prevent drug resistance: Complete engagement with the private sector is critical for prompt and accurate diagnosis. The MoHFW has already demonstrated the capacity to incentivize non-government providers and outsource services. These initiatives need to be expanded nationwide. Extend case-finding activities and deploy improved diagnostics and diagnostic strategies: Extend case-finding activities to the community level, focus on clinical risk groups and socially vulnerable groups and register and notify all cases ‘diagnosed’. Additionally, develop the necessary laboratory capacity to conduct quality-assured DST for all TB patients. Strengthen systems: Promote ownership and regular prioritized review of RNTCP within the NRHM framework and ensure adequate capacity development of existing staff. Also to take advantage of advances in technology to make DOT more patient-friendly, develop and deploy alternate approaches for monitoring treatment adherence. Coming crucially before the country goes into the next phase of programme implementation, the JMM visited field sites and held extensive consultations with various stakeholders to review the progress, challenges and plans for TB control efforts of India. It brought together national experts, affiliated Departments from the Ministry of Health and Family Welfare (MoHFW), civil society, implementing partners, technical and developmental agencies to discuss key challenges, opportunities and recommendations towards achieving Universal Access to TB care. Over the last five years, the RNTCP has examined more than 36 million persons and treated more than 7.5 million TB patients, saving more than 1 million lives. Also, over the past year, significant political and administrative commitment has been demonstrated by increases in the TB budget, a ban on inaccurate serological tests for TB, a national mandatory TB notification and the initiation of a national web-based patient tracking system.