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NTEP National Tuberculosis Elimination Programme India overview 2025
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https://www.pib.gov.in/PressReleasePage.aspx?PRID=2244661&re…
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NTEP - National Tuberculosis Elimination Programme
What is NTEP?
NTEP is India's national program to eliminate TB. In 2020, the Government of India renamed the earlier Revised National Tuberculosis Control Programme (RNTCP) to National Tuberculosis Elimination Programme (NTEP) - reflecting India's ambition to eliminate TB by 2025, ahead of the global End TB target of 2030.
India carries approximately 27% of the global TB burden, making it the highest TB-burden country in the world. TB is mandatory to notify since May 2012.
Vision & Targets (National Strategic Plan 2017-2025)
The NSP 2017-2025 targets:
| Target | Goal |
|---|---|
| TB incidence reduction | 80% reduction |
| TB mortality reduction | 90% reduction |
| Catastrophic expenditure due to TB | 0% of patients |
These are in line with WHO's End TB Strategy and SDG 3.
Four Pillars of NTEP (Detect - Treat - Prevent - Build)
1. DETECT
- Active Case Finding through TB Mukt Bharat Campaign
- Community screening and institutional screening
- Private sector engagement
- NTEP-endorsed diagnostics (Sputum smear, CBNAAT/GeneXpert, LPA, culture & DST)
2. TREAT
- Daily fixed-dose combination (FDC) regimens for Drug-Sensitive TB
- MDR-TB management with newer drugs - Bedaquiline (Bdq), Delamanid
- Shorter MDR-TB regimens
- DOT (Directly Observed Treatment)
3. PREVENT
- TB Preventive Therapy (TPT) for contacts of TB patients (including contacts of MDR-TB cases)
- BCG vaccination
- Infection control
4. BUILD
- Capacity building, training, infrastructure strengthening
- Engagement of private sector
- Accountability and governance
Programme Structure (Organogram)
NTEP operates at 5 levels (as per Park's Textbook of Preventive & Social Medicine):
| Level | Key Body |
|---|---|
| National | Central TB Division (CTD), under MoHFW; supported by NTI, NIRT, NITRD, JALMA, RMRC, BMHRC |
| State | State TB Cell (STC), headed by State TB Officer (STO); supported by STDC & IRL |
| District | District TB Centre (DTC), headed by DTO |
| Sub-district | TU (TB Unit) - covers 1 lakh population in plains, 50,000 in tribal/hilly areas |
| Peripheral | Microscopy centres at CHC, PHC, Taluka hospitals |
Key New Initiatives Under NTEP
Nikshay Portal
A case-based, web-based IT surveillance system (launched May 2012) developed by CTD + National Informatics Centre. Key features:
- TB patient registration (diagnosis, DOT provider, HIV status, outcomes)
- Culture/DST, LPA, CBNAAT tracking
- DR-TB registration
- Private sector TB notification
- Mobile app for notification
- SMS alerts to patients and programme officers
- Automated reports (case finding, sputum conversion, treatment outcomes)
Ni-kshay Poshan Yojana (NPY)
Direct cash transfer of ₹500/month to TB patients for nutritional support during treatment.
Pradhan Mantri TB Mukt Bharat Abhiyaan (PMTBMBA)
A community-level initiative that encourages individuals, organizations, and elected representatives to "adopt" TB patients and support them through treatment - nutritionally, financially, and emotionally.
TB Notification (mandatory since 2012)
All healthcare providers (public and private) are legally required to notify every TB case to the District Health Officer/CMO.
Ban on TB Serology
Import, manufacture, sale, and use of serological TB tests is banned in India - these tests have poor specificity and do not reflect active disease reliably.
99DOTS
IT-enabled adherence monitoring tool (started for HIV-TB patients, expanded further).
Drug-Resistant TB Under NTEP
India has ~1,24,000 MDR-TB cases. NTEP addresses this through:
- Decentralized treatment at medical colleges
- New drugs: Bedaquiline, Delamanid
- Shorter MDR-TB regimens
- TPT for MDR-TB contacts
- Digital tracking via Nikshay
- Centres of Excellence for DR-TB
NTEP Endorsed Diagnostics
| Test | Use |
|---|---|
| Sputum smear microscopy | Initial screening |
| CBNAAT/GeneXpert | Confirms TB + detects rifampicin resistance |
| Line Probe Assay (LPA) | Detects resistance to H and R (1st line), and fluoroquinolones/injectables (2nd line) |
| Liquid culture + DST | Gold standard for diagnosis and full susceptibility |
| Chest X-ray | Screening for presumptive TB |
Current Status (2025)
- India is making progress in case notifications and diagnostic scale-up.
- Key challenges: global TB funding decline, social stigma, high MDR-TB burden, poverty-driven transmission.
- India is a global benchmark in terms of ambition - targeting elimination 5 years before the global target.
- The PIB 2025 press release confirms continued momentum through NTEP with record-high case reporting and better diagnostics.
Source: Park's Textbook of Preventive and Social Medicine (23rd ed.), pp. 482-485; PIB India - NTEP Overview; Journal of Advanced Lung Health - A to Z of NTEP, 2025
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