National Tuberculosis Elimination Programme — Structure, Components and Targets

The National Tuberculosis Elimination Programme (NTEP), previously known as the Revised National Tuberculosis Control Programme (RNTCP), is India’s flagship public health initiative aimed at eliminating tuberculosis (TB). Formally renamed in 2020 to align with the national commitment to eliminate TB by 2025—five years ahead of the Sustainable Development Goal (SDG) target of 2030—the programme operates under the National Health Mission (NHM) within the Ministry of Health and Family Welfare. India accounts for nearly 27% of the global TB burden, making NTEP one of the world’s largest disease control initiatives.

Strategic Pillars of NTEP

The operational framework of NTEP relies on four strategic pillars outlined in the National Strategic Plan: Detect, Treat, Prevent, and Build.

Detect

• Prioritizes early and accurate diagnosis of all TB cases, including drug-resistant variants, using advanced diagnostic technology.
• Utilizes molecular diagnostic tools such as Rapid Molecular Tests including Cartridge Based Nucleic Acid Amplification Test (CBNAAT) and TrueNat machines across district levels.
• Deploys active case-finding (ACF) campaigns targeting high-risk and vulnerable populations, including contacts of TB patients, prison inmates, and urban slum dwellers.
• Integrates AI-enabled handheld X-ray devices for community-level screening in remote and hard-to-reach geographies.

Treat

• Guarantees free, standardized, and high-quality anti-TB treatment to all notified patients across public and private healthcare sectors.
• Provides fixed-dose combinations (FDCs) to reduce pill burden and improve patient compliance.
• Rollouts the shorter, highly effective 6-month BPaLM regimen (Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin) for multi-drug resistant/rifampicin-resistant TB (MDR/RR-TB).
• Mandates daily regimen dosing directly observed through digital technology platforms like 99DOTS and Medication Event Reminder Monitor (MERM) boxes.

Prevent

• Expands TB Preventive Treatment (TPT) to household contacts of pulmonary TB cases, healthcare workers, and immunocompromised individuals, such as people living with HIV.
• Administers the Bacille Calmette-Guérin (BCG) vaccine to infants under the Universal Immunization Programme.
• Implements Airborne Infection Control (AIC) protocols across health facilities to reduce airborne transmission risk.

Build

• Strengthens health systems through institutional capacity building, surveillance, multi-sectoral coordination, and adequate financing.
• Encourages community engagement, multi-ministerial convergence, and public-private partnerships to address socio-economic determinants of health.

Key Schemes and Initiatives Under NTEP

Ni-kshay Portal

• Functions as the centralized web-based platform for end-to-end case management, patient notification, drug inventory, and surveillance.
• Tracks patients across public and private health sectors and generates real-time epidemiological data.
• Acts as the operational gateway to disburse direct benefit transfer (DBT) payments to eligible beneficiaries.

Nikshay Poshan Yojana (NPY)

• Launched in April 2018 as a direct benefit transfer scheme to support the nutritional needs of registered TB patients.
• Provides financial support of ₹1,000 per month directly to the Aadhaar-linked bank accounts of notified patients throughout the treatment duration.
• Addresses undernutrition, which acts as both a primary risk factor for developing active TB and a cause for treatment failure.

Pradhan Mantri TB Mukt Bharat Abhiyaan

• Launched in September 2022 to mobilize community participation (Jan Andolan) toward national TB elimination.
• Introduces the Ni-kshay Mitra initiative, allowing individuals, corporate entities, NGOs, elected representatives, and institutions to adopt TB patients.
• Provides adopted patients with supplementary nutritional baskets, diagnostic assistance, and vocational support over a minimum period of six months.

Institutional and Organisational Structure

Central Level

• Central TB Division (CTD) within the Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare, functions as the apex policy and administrative body.
• Headed by the Deputy Director General (TB), who oversees national policy, drug procurement, budget allocation, and technical guidelines.

State Level

• State TB Cell (STC) operates under the State Health Society, headed by the State TB Officer (STO).
• Manages state-level implementation, logistics, training, and coordination with district administration.

District Level

• District TB Centre (DTC) serves as the primary operational unit, managed by the District TB Officer (DTO).
• Coordinates sub-district health facilities, Tuberculosis Units (TUs), Designated Microscopy Centres (DMCs), and peripheral health centers.

National Targets vs. Global Benchmarks

Essential Facts for Quick Revision

• The Revised National Tuberculosis Control Programme (RNTCP) was officially renamed the National Tuberculosis Elimination Programme (NTEP) in 2020.
• India aims to eliminate TB by 2025, five years ahead of the Sustainable Development Goal (SDG 3.3) global target of 2030.
• Tuberculosis is caused by the bacterium Mycobacterium tuberculosis, primarily affecting the lungs (pulmonary TB).
• Mandatory notification of all TB cases by both public and private healthcare providers was made statutory in India in 2012.
• Nikshay Poshan Yojana provides ₹1,000 per month via Direct Benefit Transfer to all notified TB patients for nutritional support.
• The Pradhan Mantri TB Mukt Bharat Abhiyaan was launched in September 2022 to engage Ni-kshay Mitras for donor support.
• The BPaLM regimen combines Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin to shorten MDR-TB treatment to 6 months.
• TrueNat and CBNAAT are cartridge-based rapid molecular diagnostic tests used for detecting TB bacilli and rifampicin resistance.
• The Ni-kshay portal serves as the national digital surveillance database for tracking TB notification, treatment adherence, and DBT payments.
• Gram Panchayats that achieve zero TB incidence and complete required screening protocols receive ‘TB-Free Panchayat’ certification.