Challenges for the RNTCP in India

Tuberculosis has been a public health problem in India since time immemorial. The disease has a devastating socio-economic cost in India, with over 450,000 people dying of TB each year--1000 every day, 1 every minute. To control the menace, Revised National TB Control Programme (RNTCP) was implemented starting in October, 1993. Around 1.6 million TB cases have been placed on treatment under RNTCP since its inception, saving over 290,000 lives. The first and foremost challenge to RNTCP is covering the entire country so that benefits are available to all Indians. Planning for nationwide coverage by 2005 for maintaining high quality of TB services is a major challenge while undertaking a rapid expansion of RNTCP Another challenge is acute shortage of manpower. Decentralisation of programme management for effective administration and sustainability of the programme to the states is another challenge. Other sectors like NGO, private practitioners Railways, ESI scheme, Medical Colleges, health care providers are to be involved in RNTCP. Despite these challenges RNTCP is performing very well. DOTS is the best available strategy for curing TB patients and that all the elements of DOTS must be adopted both in letter and in spirit.