India has been battling tuberculosis since 1962. Older adults form 14% of all the TB patients in India. Out of these, 47% were new sputum positive.
There is an ongoing National TB Program (NTP) for treating people afflicted by TB. However, due to lack of funding and zero awareness among people, the program did not find much success.
In 1992-93, the Indian government, with the help of the Swiss government, restarted the program. The Revised National TB Control Program (RNTCP) adopts the internationally recommended Directly Observed Treatment Short-Course (DOTS). This treatment is very cost-effective and systematic in its approach. This enables people in the lower strata of society to avail of these facilities. The dosage and strength of the medicines in this treatment is higher than it was before. Now, tests involving smear study are adopted at government health centres to diagnose and treat tuberculosis at early stages.
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RNTCP was applied on a large scale from 1998 onwards. By 2005, the government had expanded this program all over India. The original infrastructure of NTP was used to cut down developmental costs and enable growth on a faster rate.
Next, the government moved on to phase 2 of RNTCP. RNTCP II was based on the foundation of the first phase with an emphasis on quick and quality diagnosis and effective treatment. This could be achieved with the involvement of the private sector and the inclusion of DOTS+ for MDR TB and also offering treatment for XDR TB.
Older adults are less receptive to regular treatment and so they require a more intensive course of medication. however, TB is completely curable in older adults as well.
By 2006, RNTCP covered all areas of India. TB Units were set up. These units were sub-district supervision units, each consisting of RNCTP supervisors, and treatment conducted under the direct supervision of DOT providers. These units have also helped decentralize diagnostics and treatment.
NIKSHAY is another program running since 2012. This program has successfully achieved enlisting patient data from all parts of India, including the remotest healthcare centres.
The National Strategic Plan (NSP) 2017-2025
The National Strategic Plan (NSP) is laid out by the Government of India. It aspires to eradicate the occurrence of TB completely from India. The government has made plans in order to achieve its target by 2025. However, the effectiveness of this plan depends on the implementation of this plan by different states.
The aim of this plan is to ensure that India is totally free of TB disease and death by 2025. The four main areas – Detect, Treat, Prevent and Build are implemented by NSP. This aim is extremely ambitious on the government’s part, considering that India has 27% of the cases of TB worldwide.
However, the will of the government to implement this program is strong this time. With proper funding and implementation, the RNTCP will prove beneficial to millions in India suffering from tuberculosis.
The government kick-started this program by mandating statutory warning on tobacco and associated products. It also has concentrated on the effects of passive smoking. Poverty is another major issue that the government addresses, as poverty is one of the main reasons of people not opting for treatment for curing TB.
Also, for older adults, especially, leaving an addiction like smoking or chewing tobacco might prove to be very difficult. The government approves of and also conducts workshops that are directed at de-addiction of elderly.
India’s success lies in the fact that it has harnessed the efficiency of the private sector. The quick methods of accurate detection and swift treatment of TB has become effective due to the relentless pursuit of the government to eradicate TB from India.
In short, curing TB and removing it altogether from India is a dream come true due to Government of India’s RNTCP and working at the grassroots levels relentlessly.
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