Significant success in TB treatment, entire country receives daily regimen


Stop TB Partnership, an UN organisation giving award to Dr Sunil Khaparde, Deputy Director General (TB), Ministry of Health for best TB programme at Mexico




By Vikas Vaidya


The Daily Regimen for Tuber Culosis (TB) treatment was initiated for HIV-TB patients, all across country. It was started in five states of Bihar, Himachal Pradesh, Kerala, Maharashtra, and Sikkim from February 2017. Now, it is being expanded to entire country. There are so many factors behind the marked success in TB, the one significant amongst those is Nagpur’s Dr Sunil Khaparde, Deputy Director General Central TB Division (CTD), Ministry of Health and Family Welfare, Government of India. The success in TB treatment is recognised at international level when Dr Khaparde received award by ‘Stop TB Partnership’, a United Nations organisation at Mexico for implementing TB programme successfully.
Dr Khaparde is in city to deliver lecture during the State conference of Indian Medical Association (IMA) that begun on Friday.

TB under Revised National TB Control Programme

The Revised National TB Control Programme (RNTCP) has been implementing World Health Organization (WHO) recommended Directly Observed Treatment Short-Course (DOTS) strategy, employing the thrice weekly regimen for the treatment of tuberculosis (TB). “We are bringing in a change in the Treatment Strategy for TB patients from thrice weekly to daily fixed-dose combination (FDC) treatment. This is the beginning of the change.  The change, which will bring transformation in our approach and the intensity to deal with this disease which takes close to 5 lakh lives every year,” pointed out Dr Khaparde.
“TB elimination by 2025 is one of the highest priority program for the Government. The need to detect and put on treatment the missing cases, which usually remain hidden among vulnerable populations due to lack of awareness of access to health services should be given importance. India has now moved from alternate day regimen to daily treatment regimen”, said Dr Khaparde.
Dr Khaparde said, “ICT enabled tools for adherence support and monitoring will be used like 99 DOTS, SMS reminders, etc. 99 DOTS have been started for HIV-TB patients. The private sector holds a factual predominance of health care service delivery in India. Engaging the private sector effectively is the single most important intervention required for India to achieve the overall goal of universal access to quality TB care.”

Doctors, pharmacists to be involved


Change of treatment regimen to daily gives a big opportunity to increase access to the free anti-TB drugs provided from the programme to TB patients who seek care in private sector. The daily FDC anti-TB drugs will be made available to private pharmacy or at private practitioners to dispense to TB patients who seek care in private sector, depending upon the convenient of patient and practitioner.
“Every private health care providers and patients should be aware of this change and we should make all efforts to expand access to free daily FDC anti-TB drugs to all TB patients in private sector as well. Let us take it forward with all major hospitals, Indian Medical Association (IMA), Indian Academy of Paediatricians (IAP) and other professional medical associations to expand the access to daily FDC to all TB patients. This is the beginning of the Change to achieve our Goal to End TB,” said Dr Khaparde.


Features of daily regimen are:

o The drugs will be now taken daily (as against only 3 times weekly previously)
o The dose of drugs are according to body weight (previously it was same dose for all adults) . It means that the patients will get appropriate dosages as per body weight.
o Fixed Dose Combination (FDC) tablets will be used which will reduce pill burden (as against separate 7 tablets previously)
o Treatment regimen is expected to improvetreatment compliance
o For children, child friendly formulations as dispersible tablets
o Use of Information Technology (IT) enabled treatment adherence support system
o Regimen is acceptable to all health care providers

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