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Deepak Gupta1, L S Chauhan

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India's Revised National Tuberculosis Control Programme (RNTCP) achieves high cure rates but needs better case detection. Public-private partnerships boost detection, especially from medical colleges, highlighting the need for expanded efforts to reach vulnerable populations.

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Area of Science:

  • Public Health
  • Infectious Disease Control
  • Health Systems Strengthening

Background:

  • The Directly Observed Treatment, Short-course (DOTS) programme in India, now the Revised National Tuberculosis Control Programme (RNTCP), has experienced rapid expansion, covering over 90% of the population.
  • Despite its growth, the RNTCP has consistently met the global target of 85% cure rates for tuberculosis (TB).
  • Case detection rates, however, showed slow improvement, only recently achieving the global target of 70%.

Purpose of the Study:

  • To evaluate the impact of public-private partnerships on tuberculosis case detection rates within the RNTCP framework in India.
  • To identify areas for improvement in TB case finding, particularly for underserved populations.
  • To assess the contribution of various partners, including medical colleges, to the RNTCP's performance.

Main Methods:

  • Analysis of program data on TB case detection and cure rates across India.
  • Assessment of the role and contribution of public-private partnerships, including non-governmental organizations, private practitioners, and medical colleges.
  • Review of geographical and demographic factors influencing program reach and effectiveness.

Main Results:

  • The RNTCP has achieved and maintained high cure rates (85%) while expanding coverage to over 1 billion people.
  • Public-private partnerships have significantly contributed to improved case detection rates, with medical colleges alone accounting for 5%-15% in some regions.
  • Certain areas have demonstrated case detection rates substantially exceeding the 70% target.

Conclusions:

  • Strengthening existing public-private partnerships and initiating new strategies are crucial for enhancing TB case detection in India.
  • Targeted efforts are necessary to effectively reach poorer, vulnerable, and hard-to-reach populations to ensure equity in TB control.
  • Setting disaggregated targets, with higher goals for specific areas, sectors, and institutions, can drive further program improvements and achieve universal TB elimination goals.