TB is one of the major public health problems in India and accounts for nearly one fourth of the global burden. Every day, more than 20,000 people become infected with tubercle bacillus, more than 5,000 develop the disease and more than 1,000 die from TB. In our country, TB kills more number of adults than any other infectious disease e.g., AIDS, Malaria etc. It causes more deaths among women than those related to pregnancy and childbirth. The TB problem in the country is anticipated to increase further in view of the impact of HIV epidemic and MDR-TB. Therefore, TB control activities must be intensified on an urgent basis.

Even though, the NTP has been implemented all over the country since 1962, its performance in terms of case finding and treatment efficiency was much below expectations. This was mainly attributable to administrative and organizational shortcomings besides shortage of funds etc. Therefore, pilot projects applying the principles of DOTS were conducted since 1993 in different parts of the country, to overcome the above shortcomings. With the successful demonstration of these projects, the RNTCP is being launched since 1997 when the GOI obtained a ‘soft loan’ from the World Bank for US $142 million. Since then, RNTCP is being expanded in the country in a phased manner and by the year 1999, it had already become the second largest such programme in the world. More than 40% of the country’s population has been brought under the purview of RNTCP by the year 2001. More than 7.5 lakh patients have been initiated on treatment so far with cure rates of more than 80%. In addition, RNTCP in the states of Orissa and Andhra Pradesh is being supported by the Danish and British Governments respectively. It is proposed to cover half the country with RNTCP by 2002 and about 80% by 2004.

DOTS strategy consists of five main components viz., Political commitment, Diagnosis primarily through microscopy, Uninterrupted supply of good quality drugs, Direct observation of treatment, and Accountability. Direct observation of treatment by designated health care providers ensures that patients take the right drugs, at the right intervals, and in the right dosages.

Medical colleges play a critical role in TB control including treatment of a large number of TB cases. Medical college professors shape the attitudes of their peers and of the next generation of physicians and also act as the opinion leaders among the medical fraternity. The involvement of medical colleges in implementation of RNTCP will ensure better delivery of anti-TB services in a co-ordinated manner.

The concept of involvement of medical colleges began in 1995 with a Resolution by the World Health Assembly on “Reorientation of medical education & medical practice”. The WHO strategy to implement the resolution encourages co-ordinated reforms in health care, medical practice and medical education to optimally take up the challenge of “Health for all”. This was followed by a WHO Workshop on “TB Control and medical schools” organised in Rome from 29th to 31st October, 1997. Immediately after this Workshop, a National Consensus Conference on TB Control was organised by CTD in New Delhi in November, 1997 which was attended by leading national luminaries and senior professionals from institutes and medical colleges in India. The Conference was addressed by Sir John Crofton, President, Royal College of Physicians, U.K. & Prof John Sbarbaro of University of Colorado, U.S.A. The recommendations emerging from the Workshop included recognition of the crucial role of medical colleges in TB control efforts. Subsequently, several sensitization workshops for medical college teachers have been conducted by NTI and TRC.

In order to develop finer modalities of collaboration between medical colleges and TB control programme and to impart appropriate education and training in TB control, a two-day National Workshop on ‘Involvement of Medical Colleges in RNTCP’ was organised by GOI at the NTI on 14th and 15th September 2001.

Dignitaries on dias
L to R : Dr. G.R. Khatri, DDG (TB); Dr T.R. Frieden, MO, WHO, SEARO, New Delhi;
Dr. G.V. Nagaraj, DHS, Govt. of Karnataka; Dr. S.P. Agarwal, DGHS, New Delhi;
Sri A. Raja, Minister of State for Health & Family Welfare, New Delhi &
Dr. (Mrs) P. Jagota, Director, NTI, Bangalore.