India: Rs 710 crore to combat tuberculosis in next fiscal
The annual budget to combat tuberculosis (TB), the deadly air-borne disease, for 2012-13 will see about 80% increase over last fiscal. While, the country's annual health budget is set to increase by a meagre 13% this year, the Planning Commission has decided to raise allocation for the TB control programme to about Rs 710 crore for 2012-13.
In 2011-12, the programme had received Rs 400 crore. Health ministry officials said "The Revised National TB control programme (RNTCP) had demanded around Rs 936 crore for 2012-13. But it will get around Rs 710 crore. While the overall health budget will increase by around 13% this year, our budget will increase by nearly 80%. This is largely because we have a history of good spending. As against Rs 1,440 crore budget for TB control in the 11th Plan, we spent Rs 1,625 crore."
In the 12th Plan, the TB control budget could see an increase by over 400%. As against Rs 1,440 crore in the 11th Plan, the Union health ministry's working group has prepared a Rs 5, 825- crore programme for the 12th Plan.
The officials added, "With the outlay in the first year itself crossing Rs 700 crore, we are confident that between 2012 and 2017, we should receive close to Rs 6,000 crore in total."
India accounts for about one fifth (21%) of TB's global incidence, or an estimated 2 million cases.
So far, RNTCP has evaluated over 44 million people for TB and initiated treatment for over 12.8 million patients. It has also saved more than 2.3 million lives. In the 12th Plan, TB control will be ramped up in a big way. Plans are afoot to treat 83 lakh TB patients, including 1.2 lakh TB patients for multi-drug resistant TB. Among HIV-infected TB patients, 90% will be provided ART during TB treatment to reduce mortality. Targets also include 90% notification rate for all cases, 90% success rate for all new and 85% for re-treatment cases.
According to the 12th Plan document for TB control prepared by the ministry, the Annual Risk of TB Infection (ARTI) has reduced from 1.5% to 1.1% and prevalence has also reduced from 316 per lakh population in 2007 to 266 per lakh population in 2010.
Anti-TB drugs alone are projected to cost Rs 1,797 crore, of which 62% is for costly second-line MDR TB drugs that such patients are otherwise unable to afford themselves.
The ministry also plans to develop evidence-based treatment guidelines for TB cases resistant to drugs other than Rifampicin.
The ministry is looking at setting up 43 Culture and Drug susceptibility testing (CDST) laboratories by next year, while another 30 CDST labs will be established through public private partnerships by 2015.
The ministry aims to roll out complete geographical coverage of MDR-TB treatment services up to district level by next year. Around 120 DOTS Plus sites will be identified by 2013 each of which will cater to 10 million population for initial management of MDR-TB. India also plans to declare free universal access to drugs for all patients suffering from MDR TB. Between 2012 and 2017, India plans to put all TB patients suffering from drug resistance on treatment. Now, only 5,000 MDR TB patients get free treatment in the DOTS Plus centers. However, India is supposed to have nearly a lakh patients suffering from MDR TB.
The four countries that had the largest number of estimated cases of MDR-TB in absolute terms in 2008 were China (100,000), India (99,000), Russia (38,000) and South Africa (13,000).
"Under the 12th Plan, to be rolled out from April, both pulmonary and non-pulmonary cases will be treated. Our target is to detect 70% infectious cases and cure 85% of them. Those who have TB in lungs infect others. Lung TB accounts for about 50% of the disease, and the rest are for various other parts of the body," an official said.
Promoting rational use of anti-TB drugs to reduce drug resistance levels will also be a major part of the 12th Plan.
