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Growing cases of TB in the state manifested by delay of funds: NUN

Morung Express News
Kohima | November 23


A press conference on Tuberculosis (TB) was held on November 23 at Kohima Press Club (KPC) office. Organised by the Nagaland User’s Network (NUN) and sponsored by Treatment Action Group (TAG), the issues and challenges on Tuberculosis and its treatment in Nagaland and in India was highlighted. Delay of funds by the Government, lack of mobile TB screening, lack of awareness among public, poor treatment adherence by patience on anti-tuberculosis treatment, absence of CBNAAT in a high prevalence district like Tuensang were some of the key challenges pointed out.


“With the growing numbers of TB cases, poor response from the government has been manifested by both the State and the Central ministry through delay of funds that hamper the program,” said Ketho Angami, NUN.


He mentioned that internationally funded programs implemented by the Emanuel Hospital Association (EHA) in Phek, Wokha and Zunheboto and Catholic Health Association in Mon, Tuensang and Mokokchung have been supporting the TB program in the State.
With the inception of the Revised National Tuberculosis Program (RNTCP) in Nagaland in 2001, there are 11 district TB centres, 44 designated microscopic centres, 927 Directly Observed Treatment Centres and 2 drug resistance TB centers at Khuzama and Mokokchung.


The state has received 6 CBNAAT machines which is used for TB diagnosis meant for Kohima, Zunheboto, Mon, Tuensang, Mokokchung and Dimapur while the rest has not been installed due to poor infrastructure in the district.


Tuensang has been identified as one of the high TB/HIV district while Peren has been considered as a high drug resistance district in Nagaland. Most of the Designated Microscopy Centres (DMCs) in the state are non-functional especially in the rural areas, stated Angami.
“The state RNTCP need to look at involvement from the civil society organization in terms of designing and strategizing implementation of quality TB program side by side with development of community ownership can contribute to a qualitative intervention,” suggested Angami.


The involvement of the church in the TB program can bring about a positive impact brining about drastic change in the program, Angami added.


Abou Mere, Country Coordinating Mechanism (CCM) Member briefed on the objectives and programs of Global Fund which work towards eliminating AIDS, Tuberculosis and Malaria.  Global Fund has a strong and sustained partnership with India since 2003, with US $1.7 billion grant committed so far and US $ 1.59 billion disbursed. India is the second largest recipient of Global Fund Grant after Nigeria under the New Funding module (NFM).


Mere mentioned that there are an estimated 9.6 million new cases of TB every year or approximately 26,000 new cases every day.


One-third of those cases are missed – not diagnosed or not treated or not reported. Among those missed are those who are at the same time most vulnerable – women and children, the very poor or malnourished, prisoners, miners, indigenous populations, the elderly, and people living with HIV.


Nagaland has only one X-ray machine under RNTCP


There is only one functional X-ray machine in Nagaland state under the Revised National TB Control Programme (RNTCP), a tuberculosis (TB) control initiative of the Government of India. The X-ray machine is in Mokokchung DTC.


This was revealed in a response received from the STO, RNTCP, Directorate of Health & Family Welfare, Kohima to an RTI filed by one Renbonthung Tungoe, Advocacy Officer, Nagaland Users Network.


The state run RNTCP also appears to be lacking in diagnostic and therapeutic interventions. According to the RTI response, procurement of drugs to treat side effects of TB is not done.


However, procurement of drugs for chemoprophylaxis of children is done, with 5560 number of tablets procured during the current year (not specified).


No nutritional support is provided to Multi-Drug-Resistant Tuberculosis (MDR-TB) cases by RNTCP or the health department as provisions is not available, the RTI informed.


It also stated that there has been no report of “stock out” of RNTCP drugs nor shortage of supply from CTD except Tab INH 100/300mg, which is procured locally. The RTI response however stated that there are instances where the arrival of drugs at State Drug Store is hampered due to transportation problems.


The RTI from the RNTCP also revealed that 10,193 cases of TB cases were diagnosed and treated during 2013, 2014 and 2015.