The National Tuberculosis Elimination Programme (NTEP) is a centrally sponsored scheme under the Ministry of Health and Family Welfare (MoHFW), Government of India. Formerly known as the Revised National Tuberculosis Control Programme (RNTCP), it was renamed in 2020 to reflect the national commitment to eliminate tuberculosis (TB) from India by 2025, five years ahead of the Sustainable Development Goal (SDG) target of 2030.
Policy Framework and Strategic Pillars
The program is guided by the National Strategic Plan (NSP) 2017–2025, which adopts a multi-pronged approach to address the high burden of TB in the country. The strategy shifts from a “control” model to an “elimination” model. The NSP rests on four strategic pillars:
- Detect: Find all TB cases through intensified case finding and private sector engagement.
- Treat: Initiate and sustain treatment for all patients, regardless of their healthcare provider, using digital tracking.
- Prevent: Prevent the emergence of new cases through isoniazid preventive therapy and vaccination.
- Build: Strengthen policies, human resources, and the health infrastructure to support the elimination goal.
Key Components and Initiatives
The NTEP integrates modern diagnostic technologies and nutritional support to improve patient outcomes.
- Nikshay Poshan Yojana (NPY): Launched in 2018, this scheme provides a direct benefit transfer (DBT) of ₹500 per month to TB patients for nutritional support for the entire duration of their treatment.
- Nikshay Mitra (Community Support): An initiative under the Pradhan Mantri TB Mukt Bharat Abhiyaan where individuals, organizations, or corporates can “adopt” TB patients to provide additional nutritional and diagnostic support.
- Diagnostics: The program promotes the use of Rapid Molecular Diagnostics (like CBNAAT and TrueNat) as the first line of testing to detect drug-resistant TB, replacing older sputum smear microscopy.
- Treatment Regimen: The program employs standard treatment regimens, including the use of Bedaquiline and Delamanid for drug-resistant TB cases.
Target and Operational Facts
The following table summarizes key operational aspects of the NTEP:
| Feature | Details |
| Elimination Goal | By 2025 |
| SDG Target | By 2030 |
| Primary Financial Support | Nikshay Poshan Yojana (Direct Benefit Transfer) |
| Primary Digital Platform | Nikshay (Web-enabled patient management system) |
| Focus Areas | Drug-Resistant TB, HIV-TB co-infection, Pediatric TB |
Digital Infrastructure: Nikshay
Nikshay is the backbone of the NTEP. It serves as a unified ICT system for:
- Registration and notification of TB patients (mandatory for both public and private sectors).
- Real-time monitoring of treatment adherence and outcomes.
- Managing drug inventory and laboratory results.
- Facilitating DBT payments under the Nikshay Poshan Yojana.
Private Sector Engagement
Recognizing that a significant portion of TB patients seek care in the private sector, the NTEP has implemented the following:
- Mandatory Notification: Private practitioners and pharmacies are legally required to notify every TB case to the government.
- Patient Provider Support Agency (PPSA): Specialized agencies engage with private providers to ensure standardized TB care, testing, and drug adherence support for patients treated in the private sector.
- Provider Incentives: Financial incentives are offered for notifying cases and ensuring treatment completion.
Major Challenges to Elimination
Despite progress, the program faces several critical hurdles:
- Drug-Resistant TB (DR-TB): The emergence of Multidrug-Resistant (MDR-TB) and Extensively Drug-Resistant (XDR-TB) strains requires longer, more expensive, and more toxic treatment regimens.
- TB-HIV Co-infection: Patients with HIV are significantly more susceptible to TB; the program emphasizes integrated screening for both diseases.
- Social Determinants: Malnutrition, overcrowding, poor ventilation, and tobacco use act as significant catalysts for TB transmission.
- Stigma: Social discrimination often prevents patients from seeking early diagnosis or completing their full course of treatment.
Recent Developments
- TB Mukt Bharat Abhiyaan: A nationwide campaign aimed at creating a social movement for TB elimination, involving community leaders, Panchayati Raj Institutions, and civil society.
- Sub-National Certification: The government grants certifications to districts and states that show a significant reduction in TB incidence, encouraging competitive public health performance.
- Preventive Therapy: Expansion of TB Preventive Therapy (TPT) for household contacts of bacteriologically confirmed TB patients to break the chain of transmission.