1. The Re- emerging Threat of TB Magnitude of the Problem Associated Factors & challenges Current strategies Aamod Asmita Dr. Bala Dr. Arun Dr. Samraj Nisha Sancheela Sushma

2. Magnitude of the Problem 9.1 million cases worldwide 21% of Cases in INDIA ( 1.9 million) Estimate of 64,000 MDR- T.B 3% of new T.B cases & 12-17% among previously treated cases Budget allocation for RNTCP is 320 Cr. (2011-12)

3. Associated Factors ( MDR & XDR- TB) & Challenges faced in T.B treatment Socio- economic factors Problems with A-A-A-A Insufficient public sector MDR and XDR TB diagnosis and treatment services Poor quality of TB and MDR TB laboratory diagnosis in the private sector Lack of information about patients diagnosed with TB and MDR TB in the private sector Anti-TB drugs available without prescription and subsequent widespread irrational and irresponsible use

4. RNTCP & WHO strategies MDR Prevention through sustained high-quality DOTS implementation Improve capacity for rapid diagnosis of M/XDR TB MDR TB treatment and XDR-TB Prevention Evaluate the extent of the threat of second line drug resistance / XDR-TB Review the supply and availability of second line anti-TB drugs in India

5. Thank you! But just reminding everybody….. * A case of MDR TB is about 20-40 times more expensive to manage than a case of drug-sensitive TB, and patient suffering is magnified.

6. References RNTCP Response to Challenges of Drug resistant TB in India January 2012 (Update) TB INDIA- 2011 Revised National T.B. Control Programme- Annual Report WHO int. Global Report on Burden of Tuberculosis. TB: Dangerous comeback- Article by Ramesh Menon in Santé Publique ( The Public Health e- Magazine)