National TB Elimination Programme––Can It End TB in India by 2025: An Appraisal

Abstract

India has the ambitious plan to End TB by 2025 which is five years ahead of the global strategy. To emphasise the point and not to be complaisant, the earlier Revised National Tuberculosis Control Programme (RNTCP) has been renamed as the National Tuberculosis Elimination Programme (NTEP) since January 2020. In this comprehensive review, various issues, weaknesses, strategies and their associated problems have been discussed. Starting with the problems of tuberculosis (TB) magnitude particularly latent TB infection, co-morbid conditions, like human immunodeficiency virus (HIV), diabetes mellitus, smoking, over-crowding, under-nutrition, immune-suppression, occupations like silicosis, etc have been reviewed and highlighted. Case notification, participation of private sector, diagnostic and treatment issues are discussed. Drug resistant TB (DR-TB) has also been described. Newer advances like molecular testing and treatment modalities including short course treatment and standardised longer regimens with injection free protocols are followed by the programme so that it will be possible in future for the patients to be diagnosed early, become more compliant and the treatment success will improve. Issues regarding prevention of TB in India with chemoprophylaxis, airborne infection control and future of vaccines are discussed in brief. National Strategic Plan (NSP) for 2017-25 and the Draft NSP for 2020- 25 are also discussed with their possible impact to End TB by 2025.