Determined to end tuberculosis (TB) by 2025, the Union Health Ministry has now made it mandatory for all medical colleges to have a facility for management of Multi-Drug Resistant (MDR) TB and Anti-retroviral Therapy (ART) centres. A gazette notification in this regard has been issued on June 27.
The Board of Governors appointed in super-session of the Medical Council of India (MCI) by the Union government has amended the ‘Minimum Standard Requirement for 150 MBBS Admissions Annually Regulation, 1999’ to include this rule.
“Every medical college should have ART Centre and facility for management of MDR-TB at the time of 4th renewal for admission of 5th batch of MBBS students,” the gazette notification stated.
Following this, K.S Sachdeva, Head of Central TB Division and Project Director Revised National Tuberculosis Control Programme (RNTCP) wrote to all State TB officers that there is an urgent need to decentralise MDR-TB services so that rapid diagnosis and early initiation of treatment is possible for patients.
This is especially in the context of RNTCP’s ambitious target to eliminate TB by 2025, stated his letter dated July 11.
“Actively involving the medical colleges would present an added opportunity for decentralisation of services and also the availability of the essential MDR-TB services at tertiary level health facilities.
The National Strategic Plan (2017-2025) of RNTCP also outlines the active involvement of medical colleges for the provision of diagnostic and treatment services for TB,” Dr. Sachdeva said in the letter.
Goes undiagnosed
Despite the best efforts of health systems, about 40% of people who develop TB in India are either not diagnosed or the cases are not reported.
Even among those reported and/or diagnosed, many are lost to a follow-up, both with drug-sensitive and drug-resistant TB.
While the patients who are being treated in the private sector do not get adequate treatment support, most TB patients are affected by social and political factors such as stigma and discrimination.
Availability and access to services at a convenient time and in their social context like work, migration, gender etc. and economic barriers (for example, the cost of transport, ancillary medicines, and investigations in private sector) are also issues.
To put an end to this through community engagement, the State Health and Family Welfare Department has set up State and district TB forums.
Last year, the Union Ministry had also directed all States to expand TB diagnostics services in all Primary Health Centres (PHCs).
