Counting each day until Prime Minister of India Narendra Modi fixes 9 broken TB promises


UPDATE: On August 23rd, 2016, six networks of people living with HIV sent a letter to Dr. Rajesh Deshmukh (Program Officer, TB/HIV with the National AIDS Control Organization) re. “Request for speedy implementation of Isoniazid preventive therapy (IPT) for People Living with HIV (PLHIV) in India.” Dr. Deshmukh responded on the same day with the points below, noting that countrywide implementation of IPT is scheduled for October 2016.

With reference to your communication regarding above subject today, I would like to update as follows:
1.The procurement of drug Isonaizid (INH) required for Isonaizid preventive therapy is with Central TB Division.As per the trailing email from DADG CTD,MoHFW dated 4th Aug 2016(below), INH pre-dispatch inspection has been completed and drugs will be supplied to all states by mid Sept 2016.
2.The “Operational Manual for Implementation of IPT” has been circulated to all the SACS from NACO giving guidance for implementation of IPT.
3.Total 22 batches for training ART Centres MOs ,Staff Nurses in the country were planned and 20 batches are completed. Last training batch  ART staff will be completed in 1st week of Sept 2016.
4.All State TB officers have been sensitized in Drugs supply mechanism from State TB drugs stores to District drugs stores and ART centres in the ongoing STOs review meeting.
5.As per the trailing email from DADG CTD countrywide implementation of IPT is planned by OCT 2016.
Thanks for your communication and support for the initiative.

Isoniazid preventive therapy (IPT) prevents the progression of tuberculosis (TB) from infection to disease and helps reduce transmission in high TB incidence settings. The World Health Organization (WHO) has long recommended the provision of IPT for people living with HIV (PLHIV) and children under five years old who are household or close contacts of people with TB. Yet in India, where there are an estimated 2.1 million people living with HIV, this proven intervention is not widely accessible.

Under the National Framework for Joint HIV/TB Collaborative Activities in India, the National AIDS Control Organization (NACO) and Revised National TB Control Program (RNTCP) have been committed to the implementation of IPT for all PLHIV at least as far back as 2009.[1] Yet the Government of India does not report IPT coverage for PLHIV to the WHO.[2] And even in Indian states where there is a strong community demand for IPT, the well-documented lack of availability of isoniazid for IPT is an indicator of the Government of India’s failings to deliver this important TB preventive intervention for people affected by TB.

To take one example: in March 2016, Nagaland’s state division of the RNTCP responded to a Right to Information (RTI) request filed by the Nagaland Users Network (NUN) and reported procurement of 5,560 tablets of isoniazid (100 mg) for the provision of IPT for children—barely enough to treat 30 children with a six-month course—and stock outs of 300 mg tablets of isoniazid necessary for providing IPT for adults. The lack of implementation of IPT for PLHIV and children under five years old is not unique to Nagaland, and likely plagues most states in India.

[1] Ministry of Health and Family Welfare, Department of AIDS Control, India. National Framework for Joint HIV/TB Collaborative Activities. Government of India; November 2013.

[2] World Health Organization. Tuberculosis Country Profiles, India. Geneva: World Health Organization; 2016.

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