In India, civil society is driving change in state TB control programme
In the Indian state of Uttar Pradesh, Rs. 80 million* were released to salvage the state's TB programme, thanks in part to the lobbying of a group of civil society representatives organised with support from Project Axshya, an initiative led by The Union South-East Asia (USEA).
Uttar Pradesh (UP) is a focal point of India's battle with TB as the country's most populous state and home to nearly a fifth of the country's active TB patients. In 2010, 277,245 patients registered for TB treatment in UP out of a total 1,522,147 new TB cases in the country, and up to 17% of them might be drug-resistant**. Given this high burden, improvement of TB services is critical to TB control countrywide.
In these efforts, civil society is fast emerging as a key player. With support from USEA's Project Axshya, the TB Partnership in India hosted a meeting in July of civil society stakeholders in UP. More than 50 participants from various districts turned out for the meeting, including representatives from non-governmental organisations (NGOs), TB forums and partners of the Partnership for TB Care and Control. They shared their experiences with TB control in their respective local contexts and discussed the key challenges and gaps in the state's TB control programme.
The observations of the meeting were submitted in a memorandum to the UP state government, drawing attention those areas in immediate need of strengthening. Above all, the memorandum emphasized a need for the proper execution and implementation of provisions already part of the programme. It urged stronger supervision of Revised National TB Control Programme (RNTCP) staff, linkages between TB control programmes and existing public nutritional schemes, implementation of the ban on TB serological tests and hiring of lab technicians to strengthen diagnostic services.
A further recommendation urged the use of the un-tied fund under the National Rural Health Mission (NRHM) to improve the existing infrastructure for sputum testing. The NRHM subsequently released Rs. 80 million as a direct result of the memorandum. Dr. Nevin Wilson, Regional Director, USEA, says "This meeting is a fine example of the impact that civil society participation can have in effecting change in TB Care and Control in India, particularly by prioritising interventions where they are most needed."
* More than USD 1,500,000
** RNTCP (Revised National TB Control Programme) report, December 2011.