ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SHRI ASHWINI KUMAR CHOUBEY)
(a) & (b): No. the estimated number of Mulit-Drug Resistant (MDR)/ Rifampicin Resistant (RR) TB patients has reduced from 147000 in 2017 to 135000 for the year 2018 as per the WHO Global TB report 2018. However, the number of MDR patients diagnosed is increasing year by year due to increase in availability of diagnostic facilities and proportion of TB patients being screened for the presence of drug resistance. With the implementation of the Revised Diagnostic Algorithm and countrywide Universal- Drug Susceptibility Test (DST) in 2018, all patients diagnosed with tuberculosis are being offered rapid molecular diagnostic tests for detection of drug resistance, further leading to increased detection of Drug Resistant (DR) TB cases.
The number of MDR TB patients notified under the programme for the last 3 years are as under:
Year Number of notified MDR-TB patients
2016 33,820
2017 38,605
2018 55,519
State-wise number of MDR-TB patients diagnosed over the past three years is attached as annexure I.
(c): RNTCP is in line to achieve the desired results for addressing DRTB successfully in the country. The Government has taken up many steps in order to tackle this problem:
- Revised guidelines for Programmatic Management of Drug Resistant TB (PMDT) is being implemented since Dec’2017.
-Increase in diagnostic and management capacity for early detection and consequent earlier initiation of treatment. This will aid in decreasing mortality and cutting down transmission of the infection.
The country has 1180 functional CBNAAT sites, 89 Culture and Drug Susceptibility Testing (C-DST) laboratories certified in various technologies for drug resistance-TB detection.
Newer evidence-based regimens were introduced to improve the treatment outcomes of drug resistance TB patients.
• The Shorter MDR Regimen for MDR/RR TB patients (9-11 months of regimen instead of 24 months of conventions regimen)
• Newer drugs (Bedaquiline) containing regimen has been introduced country-wide under the program and made accessible to all districts during 2018. Total 3550 patients initiated on newer drug containing regimen till end of 2018.
• Newer drugs (Delamanid) containing regimen has been introduced in 7 states based on their capacity, to reach maximum patients.
- Various interventions like Integrated mechanism for management of Adverse Drug Reactions (ADRs), provision of patients & family counselling at the time of diagnosis and during the course of treatment, airborne infection control as well as grievance redressal system are being implemented to improve patient compliance.
-Private sector engagement is being promoted to reach out to all patients who are seeking treatment in the private sector and efforts are being made to provide them all diagnostic, treatment and care facilities, including public health action such as counselling, nutritional support, contact tracing etc.
(d): The funds provided/released to States/UTs for the last three years and current year i.e. 2015-16,2016-17 and 2018-19 is placed at Annexure II
(e): Review of activities related to prevention and management of drug resistant TB is an integral part of RNTCP, regularly conducted at National/ State/ District levels through various mechanisms like:
• Desk Review
• Review Meetings
• State Internal Evaluations (SIE)
• Central Internal Evaluations (CIE)
• Focussed thematic reviews
Through these meetings, gaps in the implementation of RNTCP policies are identified and corrective measures taken accordingly.
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