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A National Workshop on involvement of medical colleges in RNTCP was inaugurated by Shri A Raja, Honorable Minister of State for Health & Family Welfare, GOI. The Workshop organised by GOI was conducted at NTI from 14-15th September, 2001. Seventy-five professors from more than thirty medical colleges from all over India, senior officials from state and central government and representatives from WHO participated in the workshop.
In his inaugural address, the minister stated that TB control is being given the highest priority by the government and emphasised on five mandatory principles for achieving TB control viz., commitment and dedication, good quality diagnosis through quality sputum microscopy, effective treatment with good quality drugs, direct observation of treatment and accountability. He pointed out that even though more than seven lakh patients have been put on treatment under the DOTS programme of RNTCP, the lasting success would depend on the active participation of the medical colleges, not only in providing support in implementation of RNTCP but also training the future doctors.
In her Welcome Address, Dr (Mrs) P Jagota, Director, NTI said that TB and poverty go hand in hand. India unfortunately accounts for 1/4th of the global burden of TB. It was however emphasised by her that the control of TB is possible with the available technology.
Dr S.P. Agarwal, Director General of Health Services, Ministry of Health & Family Welfare, GOI in his key note address stressed on two areas of co-ordination between medical colleges and RNTCP viz., service delivery and training of UGs. Dr Agarwal expressed his satisfaction at increasing involvement of Medical Colleges in RNTCP and requested them to intensify their efforts in advocacy and operational research.
Dr Thomas Frieden, WHO MO, SEARO spoke on Global status of TB control emphasising that the problem of TB is being further threatened by the advent of HIV epidemic as well as MDR cases.
In his address, Dr M.M. Singh, Vice President, TB Association of India said that even though the NTP was being 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. Dr G.R. Khatri, Deputy Director General (TB) elaborated that pilot projects applying the principles of DOTS were conducted since 1993 in different parts of the country to overcome the shortcomings in implementation of anti-TB activities. With the successful demonstration of these projects, RNTCP has been launched since 1997 when the GOI obtained a soft loan of US $142 million from World Bank. 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 countrys population has been brought under the purview of RNTCP by the year 2001 and success rates of more than 80% have been achieved. He revealed that it has been proposed to cover half the country with RNTCP by 2002.
The role of sputum microscopy in diagnosis of TB and use of SR for treatment was discussed by Dr T Santha Devi, Deputy Director, TRC. Prof J.N. Pande, Professor of Medicine, AIIMS emphasised on the importance of scientific teaching of graduates and UGs for effective diagnosis and treatment of TB cases. According to him, medical college professors have to lead by example in the implementation of DOTS strategy of RNTCP.
Focused group discussions were held by the participants to chalk out the modalities of medical colleges involvement in RNTCP and required modifications in the medical teaching curricula for effective implementation of the policies and principles of RNTCP.
The participants were of the view that the diagnostic algorithm adopted under RNTCP is based on the sound technical rationale and should be adopted by all Medical Colleges in India. It was felt that the successful treatment strategy of DOTS adopted under RNTCP is operationally feasible and the treatment practices in all Medical Colleges should be standardised to conform with RNTCP guidelines. It was recommended that Medical Colleges should establish microscopy & treatment units in their institutions as per the technical guidelines of RNTCP for the captive population surrounding the medical colleges. The recording and reporting should be followed as per policies of RNTCP in close co-ordination with local RNTCP programme managers.
It was recommended during the workshop that the scientific basis, technical and operational guidelines of RNTCP related to diagnosis, case finding and treatment of TB cases should be appropriately incorporated in the teaching curriculum. The students should be given practical training through field visits and clinical postings at RNTCP centres. TB control and RNTCP related topics should be considered as priority areas for dissertations and research
It was also recommended that the representatives from medical colleges should be included as members in the District/State TB Society and should be involved in planning, programming, implementation, monitoring, training and evaluation of RNTCP at district, state and national levels. The medical colleges should provide referral services in the management of complicated cases and culture and drug susceptibility testing
It was decided that a core group consisting of leading professors of medical colleges may be constituted with the responsibility to facilitate and monitor the involvement of medical colleges in RNTCP, with necessary support from CTD, GOI.
The workshop concluded
with vote of thanks by Dr. G.R. Khatri, DDG(TB).
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