Lok Sabha Question No. 136 (UNSTARRED), answered on 2018-02-02
Subject: Elimination of Tuberculosis
Ministry: HEALTH AND FAMILY WELFARE
Asked by: RAVINDRA VISHWANATH GAIKWAD, G. HARI, AJAY (TENI) MISRA, SUSHIL KUMAR SINGH, VINOD KUMAR BOIANAPALLI, RAYAPATI SAMBASIVA RAO, DHARAM VIRA GANDHI, K. ASHOK KUMAR

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 136 TO BE ANSWERED ON 2 ND FEBRUARY, 2018

## ELIMINATION OF TUBER CULOSIS

## 136. PROF. RAVINDRA VISHWANATH GAIKWAD:

SHRI G. HARI:

SHRI AJAY MISRA TENI:

SHRI SUSHIL KUMAR SINGH:

SHRI B. VINOD KUMAR:

SHRI RAYAPATI SAMBASIVA RAO:

SHRI DHARAM VIRA:

SHRI K. ASHOK KUMAR:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the Government has formulated any national plan for eradication of Tuberculosis in the country, if so, the details thereof alongwith the number of cases/deaths recorded during each of the last three years and the current year, State/ UT - wise;
- (b) whether the Government has asked theState Governments to hold quarterly reviews of the Tuberculosis  control programme  in  their  States,  if  so,  the  details thereof  along  with  other programmes/schemes rolled out and funds allocated by the Government for early detection and eradication of Tuber culosis in the country;
- (c) whether it is true that India will eliminate tuberculosis before the global deadlines i.e. on or before  2025  as  against the  target  of  2030,  if  so,  the  details  thereof along  with  strategic  plan towards its elimination;
- (d)  whet her  the  Government  plans  to roll  out  a  mechanism  for  online  monitoring, providing nutritious food and financial assistance to TB patients, if so, the details reof; and
- (e)  the  details  of  steps  taken  by  the Governm nt  to  provide  various  TB  drugs especially Bedaquiline in the country?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

## (SHRI ASHWINI KUMAR CHOUBEY)

(a) to (c) : The  National  Strategic  Plan  (NSP)  for  Tuberculosis  (2017 - 25)  has  been formulated by the Ministry of Health and Family Welfare with a vision to eliminate TB by 2025, five  years  ahead  of  the  Sustainable  Development  Goal  (SDG)  and  ten  years  ahead  of  WHO target.

In  addition  to  the  existing  strategies  under  Revised  National  Tuberculosis  Co Programme (RNTCP), the NSP focuses on:

- early diagnosis of all the TB patients, prompt treatment with quality assured dru treatment Regimen,
- suitable patient support systems to promote adherence,
- engaging with the patients seeking care in the private sector,
- prevention strategies including Active Case Findings,
- contact tracing in high risk / vulnerable population,
- airborne infection control, and
- Multisectoral response to address social determinants.

Number of TB cases notified to the programme in each of the last three years and current year State/UT -wise is enclosed at Annexure I .

Number of deaths notified to the programme in each of the last three years and cu year State/UT -wise is given at Annexure II .

The Ministry of Health & Family Welfare (MOHFW) has requested all the States/UTs to hold quarterly reviews of the Programme. The Ministry of Health and Family Welfare has ta several  new  initiatives  for  strengthening  early  detection  and  treatment  of  Tuberculosi country, the details of which ar e as under:

- Introduction of Daily Regimen for treatment of Tuberculosis across the country
- Expansion of molecular diagnostics i.e CBNAAT for early diagnosis of Drug Resista Tuberculosis (DR - TB)
- Introduction  of  Universal  Drug  Susceptibility  Testing  for  al l  diagnosed  TB  patients, including patients in private sector
- Introduction  of  newer  drug  i.e.  Bedaquiline  for  DR - TB  treatment  under  Conditional Access Programme
- Active Case Findings for reaching the unreached vulnerable population in more than distric ts so far.

The funds allocated by the Ministry for Financial Year 2017 - 18 is Rs 1840 Crore.

(d): The Ministry has launched the online portal called NIKSHAY for case based monitorin and surveillance of notified TB patients.

Incentives for nutritional and financial support to the TB patients @ Rs. 500/ -per patients per month has been proposed in the General Budget 2018.

(e): The Revised National  Tuberculosis Control Programme (RNTCP)  provides free treatment by fixed dose ant i - tuberculosis drugs to all patients. Bedaquiline is presently be provided  at  21  sites  within  public  health  in  5  States,  under  close  monitoring  of  RNTC ' Conditional Access Programme ' .

Capacity building of the States officials for scaling up of ' Conditional  Access Programme' for Bedaquiline across the country has been completed and scale up of the access other sites in the country is ongoing.

State/UT-wise Case Notification of TB for India

| S No   | State/UTs           |    2014 |    2015 |    2016 |    2017 |
|--------|---------------------|---------|---------|---------|---------|
| 1      | Andaman &Nicobar    |     756 |     605 |     534 |     631 |
| 2      | Andhra Pradesh      |   98836 |   68922 |   74373 |   83242 |
| 3      | Arunachal Pradesh   |    2850 |    2779 |    2788 |    3059 |
| 4      | Assam               |   40004 |   39978 |   40851 |   39170 |
| 5      | Bihar               |   76944 |   81731 |   97001 |   94393 |
| 6      | Chandigarh          |    3018 |    3320 |    3413 |    5948 |
| 7      | Chhattisgarh        |   32124 |   35339 |   39484 |   39829 |
| 8      | Dadar& Nagar Haveli |     469 |     553 |     552 |     806 |
| 9      | Daman & Diu         |     279 |     414 |     487 |     452 |
| 10     | Delhi               |   55702 |   59309 |   62706 |   58898 |
| 11     | Goa                 |    1814 |    1893 |    1966 |    1907 |
| 12     | Gujarat             |   93074 |  109828 |  126665 |  144125 |
| 13     | Haryana             |   43796 |   44970 |   47545 |   39041 |
| 14     | Himachal Pradesh    |   15000 |   14965 |   14961 |   15326 |
| 15     | Jammu & Kashmir     |   10331 |   10046 |    9937 |    9319 |
| 16     | Jharkhand           |   37049 |   35985 |   39515 |   42033 |
| 17     | Karnataka           |   62943 |   64684 |   68462 |   78377 |
| 18     | Kerala              |   24740 |   29529 |   27293 |   20776 |
| 19     | Lakshadweep         |      27 |      40 |      23 |      27 |
| 20     | Madhya Pradesh      |  110949 |  111317 |  129915 |  133939 |
| 21     | Maharashtra         |  155768 |  182974 |  195139 |  190262 |
| 22     | Manipur             |    2506 |    2370 |    2393 |    2663 |
| 23     | Meghalaya           |    5295 |    5568 |    4586 |    3934 |
| 24     | Mizoram             |    1996 |    2139 |    2205 |    1995 |
| 25     | Nagaland            |    3531 |    3504 |    2821 |    2924 |
| 26     | Orissa              |   46677 |   46630 |   43851 |   68868 |
| 27     | Pondicherry         |    1409 |    1290 |    1421 |    1601 |
| 28     | Punjab              |   39259 |   39611 |   39836 |   44572 |
| 29     | Rajasthan           |  106623 |  102032 |  106756 |  103107 |
| 30     | Sikkim              |    1630 |    1400 |    1539 |    1227 |
| 31     | Tamil Nadu          |   88435 |   86729 |   96079 |   90946 |
| 32     | Telangana           |   18655 |   40934 |   45003 |   46910 |
| 33     | Tripura             |    2507 |    7404 |    2374 |    1664 |
| 34     | Uttar Pradesh       |  259995 |  265454 |  297746 |  302163 |
| 35     | Uttarakhand         |   15578 |   15590 |   15081 |   16416 |
| 36     | West Bengal         |   89827 |   88147 |   89656 |   95893 |
|        | TOTAL               | 1550356 | 1607983 | 1754957 | 1772033 |

| ANNEXURE 2                                    | ANNEXURE 2                                    | ANNEXURE 2                                    | ANNEXURE 2                                    | ANNEXURE 2                                    |
|-----------------------------------------------|-----------------------------------------------|-----------------------------------------------|-----------------------------------------------|-----------------------------------------------|
| State-wise deaths reported due to TB in India | State-wise deaths reported due to TB in India | State-wise deaths reported due to TB in India | State-wise deaths reported due to TB in India | State-wise deaths reported due to TB in India |
| State                                         | 2013                                          | 2014                                          | 2015                                          | 2016 (till October)                           |
| Andaman & Nicobar                             | 18                                            | 38                                            | 17                                            | 20                                            |
| Andhra Pradesh                                | 5169                                          | 3089                                          | 2764                                          | 3997                                          |
| Arunachal Pradesh                             | 67                                            | 68                                            | 74                                            | 33                                            |
| Assam                                         | 1678                                          | 1759                                          | 1785                                          | 1199                                          |
| Bihar                                         | 2139                                          | 1914                                          | 1800                                          | 1180                                          |
| Chandigarh                                    | 65                                            | 48                                            | 65                                            | 67                                            |
| Chhattisgarh                                  | 782                                           | 1350                                          | 1436                                          | 1576                                          |
| Dadar &Nagar Haveli                           | 15                                            | 18                                            | 18                                            | 15                                            |
| Daman &Diu                                    | 8                                             | 9                                             | 14                                            | 5                                             |
| Delhi                                         | 1316                                          | 1281                                          | 1296                                          | 582                                           |
| Goa                                           | 76                                            | 52                                            | 45                                            | 42                                            |
| Gujarat                                       | 4094                                          | 4312                                          | 4657                                          | 4208                                          |
| Haryana                                       | 1628                                          | 1709                                          | 1700                                          | 1106                                          |
| Himachal Pradesh                              | 518                                           | 537                                           | 539                                           | 485                                           |
| Jammu &Kashmir                                | 303                                           | 292                                           | 316                                           | 144                                           |
| Jharkhand                                     | 1332                                          | 1465                                          | 1192                                          | 587                                           |
| Karnataka                                     | 4356                                          | 4348                                          | 4192                                          | 3390                                          |
| Kerala                                        | 1158                                          | 1084                                          | 953                                           | 702                                           |
| Lakshadweep                                   | 1                                             | 2                                             | 1                                             | 0                                             |
| Madhya Pradesh                                | 3174                                          | 3574                                          | 3761                                          | 2961                                          |
| Maharashtra                                   | 7716                                          | 7629                                          | 6904                                          | 4329                                          |
| Manipur                                       | 73                                            | 75                                            | 77                                            | 33                                            |

| Meghalaya     | 202   |   190 |   214 |    89 |
|---------------|-------|-------|-------|-------|
| Mizoram       | 77    |    87 |    93 |    53 |
| Nagaland      | 201   |    77 |    44 |    45 |
| Orissa        | 2332  |  2451 |  2380 |  1455 |
| Pondicherry   | 66    |    64 |    55 |    44 |
| Punjab        | 1678  |  1989 |  1786 |  1264 |
| Rajasthan     | 3599  |  3428 |  3667 |  3418 |
| Sikkim        | 47    |   222 |    38 |    46 |
| Tamil Nadu    | 4005  |  4095 |  4205 |  3058 |
| Telangana     | *     |  2050 |  1926 |     0 |
| Tripura       | 106   |   141 |   162 |    56 |
| Uttar Pradesh | 7946  |  8736 | 10233 |  6803 |
| Uttarakhand   | 500   |   537 |   512 |   269 |
| West Bengal   | 5184  |  4506 |  4376 |  3384 |
| TOTAL         | 61629 | 63226 | 63297 | 46645 |

* Data included in respect of Andhra Pradesh.