With a view to further control the tuberculosis in the country, the Directly Observed Therapy – Short course (DOTS) plus programme, currently available in 10 states in the country, will be extended to all the states by the end of this year.

The Revised National TB Control Programme (RNTCP) widely known as DOTS, which is a WHO recommended strategy, is being implemented as a 100 per cent centrally sponsored scheme in the entire country. Under the programme, diagnosis and treatment facilities including supply of anti-TB drugs are provided free of cost to all TB patients. More than 12,700 microscopy centres have been established in the country. All government hospitals, Community Health Centres (CHC), Primary Health Centres (PHCs), Sub-centres will be DOT Centres. In addition, NGOs, private practitioners (PPs) involved under the RNTCP, community volunteers, anganwadi workers, Women Self Groups etc. will also be function as DOT providers/DOT Centres.

The RNTCP also initiated the DOTS Plus services for the management of multi-drug resistant TB (MDR-TB) in 2007 in the States of Gujarat and Maharashtra. Currently these services are available in 10 States -- Gujarat, Maharashtra, Andhra Pradesh, Delhi, Kerala, Haryana, Tamil Nadu, Rajasthan, West Bengal and Orissa.

RNTCP has rolled out a plan for covering all States by the end of 2010. The programme is establishing a network of accredited culture and drug sensitivity testing (DST) laboratories to provide diagnostic and follow up services and DOTS- Plus sites for initiating and monitoring the treatment of MDR-TB patients. Management of MDR-TB is much more complicated than standard first-line anti-TB treatment, and requires a concerted effort by all health staff, and special efforts by programme staff to detect and refer MDR suspects and to support and supervise treatment of MDR-TB patients, sources said.

As per the latest estimate by WHO, in 2009, out of the estimated global annual incidence of 9.4 million TB cases, 1.98 million were estimated to have occurred in India, thus accounting for a fifth of the global burden of TB. The mortality in the country has reduced by 43 per cent from an estimated 42/lakh population in 1990 to 24/lakh population in 2009, and the prevalence of TB in the country has reduced by 67 per cent, from 568/lakh population to 185/lakh population during the same period. In 2009, the Programme reached the key milestone of 70 per cent case detection and 85 per cent cure of new smear positive patients.