Friday, October 1, 2010

TUBERCULOSIS-a need for an honest appraisel

India is supposedly home to one fifth of the tuberculosis cases in the world.According to the WHO reports nearly two million people contract the disease every year,while 2.8% of these are supposed to be drug-resistant.As per the government statistics the coverage of RNTCP is supposed to be one hundred percent with a success rate of 86%.With two million cases coming in every year, even if the programme were to be as successful as it seems to suggest,we have a major public health problem at hand.
The WHO objective for tuberculosis management suggests a case detection rate of more than 70% which according to the reports have been achieved in most places and the RNTCP is I hear, looking towards a target of one hundred percent.Is it a feasable target in the current ground scenario?
Is there a need to put into place some radical legislations before we can even think of getting somewhere.
Does the government of India need to have an honest appraisel of the current ground situation at all levels before we think of putting in place policies which are going to decide where India is going to go as far as tuberculosis is concerned in the next decade or are we going to continue to put on blinkers and bull-doze our way while millions of Indians continue to become prey to this terrible disease.


Andi and Sheba Eicher said...

Thanks for saying this Cherring. Have we seen any data that has shown less TB in any place where the RNTCP has been operational?

Who would you suggest to be the ones to do the appraisal?

pixi said...

RNTCP in a model unit would I guess, be Satbarwa but we have zeroed down on other reasons like migration(and factors like smoking,over-crowding,etc in it) as the real culprit there.
I guess the appraisel would have to be done by a third party-(A proper research perhaps)
Why not EHA?(ha!)
I hope the intermittant therapy has been thoroughly tested under ideal situation (Not considering HIV,where I guess it is not enough-atleast that's what experience seem to tell us).

Now anyways ,the WHO guidelines seem to be leaning towards daily regime...if you have seen them.(Not that it mattters if it is successful!but I know quite a lot of people who would not agree with this!)
I believe around 70 percent of the TB drugs actually reach the patients through the hands of the private practitioners so we cannot really lay the blame on RNTCP or the thrice weekly regime!.
October 5, 2010 4:44 AM