Lok Sabha Question No. 1029 (UNSTARRED), answered on 2017-07-21
Subject: TB Cases
Ministry: HEALTH AND FAMILY WELFARE
Asked by: ELUMALAI VELLAIGOUNDER, ARJUNLAL MEENA, RAYAPATI SAMBASIVA RAO, K. MARAGATHAM, RAM CHARITRA, DEVJI MANSINGRAM PATEL, RAHUL KASWAN, KAUSHALENDRA KUMAR

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE

## DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1029 TO BE ANSWERED ON 21 ST JULY, 2017

## TB CASES

## 1029. SHRI V. ELUMALAI:

SHRI ARJUN LAL MEENA:

SHRI RAYAPATI SAMBASIVA RAO:

SHRIMATI K. MARAGATHAM:

SHRI RAM CHARITRA NISHAD:

SHRI DEVJI M. PATEL:

SHRI RAHUL KASWAN:

SHRI KAUSHALENDRA KUMAR:

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

- (a) whether the number of cases of Tuberculosis (TB) and Multi - Drug Resistant TB (MDRTB) and attributable deaths reported in the country have increased during each of the last three years and the current year, State/ UT - wise;
- (b) if so, the details thereof and the steps taken/proposed to be taken by the Governm ent for identification,  detection  and treatment  of  TB/MDRTB/  XDR- TB  casesalong  with  the  funds allocated and utilised during the said period, State/UT - wise;
- (c) whether the Government has finalised an aggressive national strategy to end Tuberculosis by 2025 and if so, the details thereof; and
- (d) whether India plans a national strategy with the aim for new breakthrough at ending TB in eleven countries of the region through political and financial commitment and enhanced regional cooperation and if so, the details thereof?

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND

## ANSWER FAMILY WELFARE

(SHRI FAGGAN SINGH KULASTE)

- (a) As per WHO's Global Tuberculosis Report 2016, the TB epidemic is larger than previously estimated, reflecting new surveillance and survey data from India. However, the number of TB deaths and the TB incidence rate continue to fall globally and in India.

The number of Tuberculosis (TB) and Multi - Drug resistant TB cases reported under the Revised National Tuberculosis Control Program me (RNTCP) are as under;

| Year           |   TB Cases | MDR - TB cases   |   Deaths |
|----------------|------------|------------------|----------|
| 2014           |    1550356 | 24073            |    61888 |
| 2015           |    1607983 | 26966            |    63226 |
| 2016           |    1754957 | 32682            |    63295 |
| Till June 2017 |     747311 |                  |    29457 |

Over the last 3 years, the increase in detection of Tuberculosis cases has been primarily due to the increase in notification of TB cases from the private sector. Similarly, the d MDR - TB cases has been increasing due to availability of more diagnostic facilities for M and coverage of the entire country through Programm atic Management of Drug Resistant TB under RNTCP.

## ( b) : The RNTCP is being implemented under the aegis of the National Health Mission wit the key focus areas as under :

- strengthening and improving quality of basic TB services,
- addressing TB HIV co - infect ion, other co - morbidities and MDR - TB
- engaging with care providers both in the public and the private sector
- targeted  intervention  in  the  vulnerable  population  and  strengthening  urban  TB  co along with active case finding activities
- scaling up of newer molecular diagnostics for TB (CBNAAT), in the health system, for early diagnosis of MDR TB
- leveraging of Information Communication Technology for enhancing TB notification an strengthening of monitoring.

The details of funds allocated and utilized during the said period is placed at Annexure.

(c): Yes, the National Strategic Plan (NSP) for Tuberculosis (2017 - 2025) has been finalised. In  addition  to  the  existing  strategies  under  RNTCP,  the  NSP  addresses  requirements achieving the SDG and End TB target s for India. The focus is on early diagnosis of all the patients, prompt treatment with quality assured drugs and treatment regimens along with s patient support systems to promote adherence. Emphasis has been on engaging with the pat seekin g care in the private sector. This is supplemented by prevention strategies includin case  finding  and  contact  tracing  in  high  risk  /  vulnerable  population  and  airborne  i control.

(d): Yes ,  the  'Ministerial  Meeting  towards  Ending  TB  in  the South  East  Asia  Region  by 2030' was held during 15 - 16th March 2017 in New Delhi, wherein a Call for Action Resolution to End TB was adopted by the Eleven Country Ministers / Vice Ministers. As per the resolu the signatory Governments are committed to Ending TB through political, financial and regional cooperation.

## Revised National TB Control Programme State wise Allocation and Utilization (Cash & Kind)

| Sl.No.   | Name of the State / UT   | 2014-15    | 2014-15     | 2015-16    | 2015-16         | 2016-17    | 2016-17     |
|----------|--------------------------|------------|-------------|------------|-----------------|------------|-------------|
| Sl.No.   | Name of the State / UT   | Allocation | Utilization | Allocation | Utilization     | Allocation | Utilization |
| 1        | Andhra Pradesh           | 2861.96    | 2308.49     | 2200.34    | 2002.85         | 2194.68    | 2043.35     |
| 2        | Andaman & Nicobar        | 87.15      | 88.34       | 90.90      | 110.86          | 90.90      | 110.48      |
| 3        | Arunachal Pradesh        | 565.36     | 580.95      | 552.32     | 585.22          | 564.48     | 644.34      |
| 4        | Assam                    | 4303.74    | 1549.79     | 2527.13    | 2622.95         | 2776.33    | 2897.69     |
| 5        | Bihar                    | 4094.59    | 2589.91     | 2963.81    | 2757.19         | 2962.00    | 2268.8      |
| 6        | Chandigarh               | 154.54     | 140.70      | 156.14     | 144.07          | 156.14     | 148.01      |
| 7        | Chattisgarh              | 1440.6     | 1540.53     | 1401.08    | 1587.32         | 1398.15    | 2169.45     |
| 8        | D & N Haveli             | 68.05      | 50.68       | 72.03      | 67.59           | 72.03      | 62.65       |
| 9        | Daman & Diu              | 43.47      | 21.77       | 45.98      | 43.21           | 45.98      | 39.28       |
| 10       | Delhi                    | 1820.02    | 1350.22     | 1705.12    | 1605.19         | 1018.43    | 1694.01     |
| 11       | Goa                      | 116.34     | 104.74      | 127.78     | 105.25          | 127.61     | 121.87      |
| 12       | Gujarat                  | 4857.52    | 4698.01     | 3298.04    | 5056.34         | 3282.10    | 5100.79     |
| 13       | Haryana                  | 1292.26    | 1419.57     | 1207.93    | 1093.27         | 1204.96    | 1206.81     |
| 14       | Himachal Pradesh         | 581.22     | 515.31      | 837.57     | 834.98          | 833.82     | 974.19      |
| 15       | Jammu & Kashmir          | 943.43     | 552.05      | 1038.26    | 892.45          | 1036.78    | 700.61      |
| 16       | Jharkhand                | 1783.56    | 1583.85     | 1512.16    | 1302.31         | 1511.23    | 1366.24     |
| 17       | Karnataka                | 3195.23    | 2683.65     | 3186.19    | 3591.43         | 3177.65    | 4006.63     |
| 18       | Kerala                   | 1440.91    | 1253.73     | 1395.33    | 1056.88         | 1393.01    | 1082.1      |
| 19       | Lakshadweep              | 35.39      | 8.33        | 37.95      | 27.31           | 37.95      | 24.22       |
| 20       | Madhya Pradesh           | 3081.84    | 3893.81     | 2880.71    | 3287.48         | 2878.14    | 3089.98     |
| 21       | Maharashtra              | 6657.74    | 9695.28     | 8085.75    | 8058.82         | 8059.40    | 8143.71     |
| 22       | Manipur                  | 657.22     | 398.06      | 524.57     | 398.77          | 548.31     | 485.79      |
| 23       | Meghalaya                | 550.67     | 457.57      | 427.62     | 441.28          | 453.95     | 523.35      |
| 24       | Mizoram                  | 414.39     | 385.20      | 392.75     | 341.42          | 402.29     | 452.72      |
| 25       | Nagaland                 | 596.41     | 364.14      | 460.49     | 445.42          | 477.38     | 520.47      |
| 26       | Orissa                   | 2141.81    | 1856.30     | 1991.54    | 2053.24         | 1986.79    | 2524.08     |
| 27       | Puducherry               | 183.56     | 172.27      | 187.88     | 163.47          | 110.57     | 206.31      |
| 28       | Punjab                   | 1207.19    | 1511.48     | 1273.22    | 1135.85         | 1270.01    | 1028.68     |
| 29       | Rajasthan                | 3653.38    | 3375.79     | 2792.23    | 2741.05         | 2781.23    | 2842.78     |
| 30       | Sikkim                   | 242.98     | 428.77      | 426.92     | 442.29          | 474.88     | 511.46      |
| 31       | Tamilnadu                | 3131.84    | 3850.35     | 3367.31    | 4028.96         | 3353.00    | 4191.06     |
| 32       | Tripura                  | 583.71     | 172.88      | 290.20     | 259.18          | 300.38     | 322.72      |
| 33       | Uttar Pradesh            | 7631.54    | 10785.86    | 7350.90    | 11610.11        | 7337.90    | 13863.35    |
| 34       | Uttrakhand               | 661.14     | 852.15      | 651.62     |                 | 650.44     | 707.86      |
| 35       | West Bengal              | 3834.82    | 3253.00     | 3187.70    | 930.21          | 3183.10    | 4128.96     |
| 36       | Telangana                | 2045.38    | 814.87      | 1672.53    | 3513.61 2462.18 | 1667.00    | 2040.75     |
|          | Total                    | 66960.96   | 65308.40    | 60320.00   | 67800.01        | 59819.00   | 72245.55    |

## Annexure

(Rs. In lakhs)

| Year                          |   Budget Estimate(BE)(in lakhs) |   Expenditure ( in lakhs) |
|-------------------------------|---------------------------------|---------------------------|
| 2017-18(till 17 th July 2017) |                            1840 |                      86.4 |