Public-private mix TB activities in Meerut, Uttar Pradesh, North India: delivering dots via collaboration with private providers and non-governmental organizations.

BACKGROUND: We evaluated the contribution of public-private collaboration between the Indian tuberculosis (TB) programme and the private health sector (including non-governmental organizations and private providers) to TB case-detection and treatment outcomes in Meerut district, India. METHODOLOGY: District TB registers from January 2001-June 2003 were reviewed. RESULTS: The 2002 new AFB-positive case-notification rate (103/100,000 population) in Meerut exceeded national targets. Of the 7,062 new AFB-positive patients registered, 2,084 (29%) were detected at private sector microscopy and DOTS treatment centres; treatment outcomes met programme targets. CONCLUSION: Public-private collaborations can be successfully implemented at the district level in India, and have the potential for substantial contributions to TB control efforts in India.

Status report of the Revised National Tuberculosis Control Programme: January 2003.

Tuberculosis (TB) remains a serious public health problem in spite of DOTS programme recommended by WHO. One person dies from TB in India every minute. Revised National TB Control Programme (RNTCP) is playing a major role in global DOTS expansion. DOTS coverage has expanded from 2% of the population in mid-1998 to 57% by the end of January, 2003. RNTCP has made a significant contribution to public health capacity. The programme has saved the people of India hundreds of millions of dollars. Monitoring the clinical course using smear microscopy and accurately reporting treatment outcomes is essential in well-functioning DOTS programme. RNTCP has invested heavily and made significant strides in maintaining and improving quality DOTS. State and district level programme reviews are a key component of the process. RNTCP has established guidelines for the involvement of the private sector and medical colleges. A member by ongoing technical activities will improve RNTCP's surveillance and monitoring systems. However a challenge lies with the programme and a collective effort is welcome.

Role of WHO recruited consultants in successful implementation and expansion of the DOTS programme in India.

For successful implementation of DOTS in India, many factors have played important part and one of which is the use of WHO-contracted local consultants. WHO had recruited consultants known as RNTCP Medical Consultants (RMCs) and assigned them to States and districts to provide technical assistance to the State and District TB Officers. In the districts the RMCs assist in preparation of action plans and interact with district and State authorities. The RMC network is funded by WHO and the Canadian International Development Agency. The assignment of RMCs has resulted in much more rapid implementation of the DOTS strategy with sustainable improvement in the quality of the programme in implementing districts.