Wanting a more effective management of the tuberculosis (TB) programs, the World Health Organization (WHO) said that “financial sustainability and manageability” was required in addition to mere funding. Federal Health Minister Anbumani Ramdoss said had earlier disclosed a Rs. 1,156 crore (USD 251 million) program mostly based on a loan of Rs. 950 crore (USD 206 million) from the World Bank
Over the years, India had implemented one of the largest TB control programs in the world through free treatment of 100,000 patients every month and registering a success rate of 86%. This new funding is for a Revised National Tuberculosis Control Programme (RNTCP) for the next 5 years in addition to the National Rural Health Mission (NRHM). A new approach to fighting TB is required because of the emergence of a Multi-Drug Resistant (MDR) variant of the disease and the increasing prevalence of TB in those infected with HIV.
According to Government sources, the incidence of MDR-TB in India is still less than 3% but it is not clear if this is well surveyed figure of a guesstimate. As seen in the case of the AIDS survey, India does not have a strong sampling, surveying, and reporting mechanism. Regardless, the Health Ministry says it has developed a national plan for implementing an advanced TB control program that would be established in phases through a network of accredited quality assured Intermediate Reference Laboratories and Directly Observed Treatment Sites as per the international guidelines for culture and drug sensitivity testing services and enrolling and providing treatment to MDR-TB cases. According to international experience, the treatment of MDR-TB is over 300 times more expensive than for non-resistant TB and uses drugs that have many side effects while taking more than three years.
However, WHO cautioned that while this is a good plan it also needs to be financially sustainable in the future and the efforts themselves are manageable and optimal. It recommended the merger of the RNTCP and NRHM programs as they do have common goals and have a natural duplication of resources in terms of personnel, equipment, and resources. Besides the skill sets and resources of both projects appear to be complementary. For instance, the NRHM does not a great access that the RNTCP can provide while the RNTCP does not have installed infrastructure that the NRHM can provide.
Ramdoss said that the Government is “trying to consolidate the program at the Central and State levels and would be integrated with the NRHM at the district level” therefore promising a merger. However, he did not specify a timetable.
