Free TB treatment plan a hit in Mumbai, ministry to replicate project in other cities

Of the newly notified cases from the private sector, 6,882 have already started their free TB treatment.

Written by Tabassum Barnagarwala | Mumbai | Published: October 3, 2015 12:56:12 am

A YEAR after the Ministry of Health And Family Welfare (MoHFW) introduced the pilot project to offer free tuberculosis (TB) treatment for city patients, it has come to the fore that a significant 6,882 tuberculosis patients have been benefited by the service.

With the success of the pilot project in Mumbai, a similar programme has now been launched at Nagpur and the ministry plans to start it in several other cities in India as well. Anyone can avail this service, provided they go to a doctor who is registered under the programme.

According to data gathered from the Mumbai TB cell under the Revised National Tuberculosis Control Programme (RNTCP), 10,675 new patients have registered under the system, of which 656 are patients with multi-drug resistant TB.

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Of the newly notified cases from the private sector, 6,882 have already started their free TB treatment.

Till now, the government funded-RNTCP only catered to patients coming to public hospitals. But by roping in private nursing homes, clinics and hospitals to provide free treatment to patients, the ministry expects to reduce the high dropout rate in long-term treatment.

Additionally, experts said the government will be in a better position to frame future policies with more accurate data on TB from both public and private sectors.

The programme, called Private Practitioner Interface Agency (PPIA), was started in August, 2014, under the civic body’s supervision. In a year, 130 hospitals and nursing homes, 134 chemists and 102 private testing laboratories have been registered under the scheme.

“The system is very efficient. If a patient goes to a doctor registered with the PPIA and tests positive for TB, the doctor issues him vouchers for x-ray and medicines. The chemists and labs provide free medication or diagnostic tests when the patient produces the voucher.

The government then reimburses the chemists and labs. The patient is assured hassle-free treatment,” said Dr Daksha Shah, head of TB Control Unit in Mumbai.
Since August 2014, the government has spent Rs 70 lakh on subsidies for diagnostics and more than Rs 1 crore on subsidies for anti-TB drugs.

Under the programme, a patient only has to pay the private doctor’s consultation fee. The only drawback of the programme, however, is that it does not cater to second-line TB treatment.

“Multi-drug resistant patients will have to get registered in RNTCP for free treatment,” said Shah.

Explaining the need to involve private sector in TB control, Dr Shibu Vijayan from NGO Parth, which partnered with the Brihanmumbai Municipal Corporation (BMC0) for the entire programme, said people prefer going to a private doctor for treatment instead of a public hospital.

“To reduce abandonment of treatment, free medicines are necessary as treatment of TB can take a year or more and several do not have the spending capacity.”
He added that initially the programme faced challenges of payment and reimbursement delays.

“We then switched to electronic records, which reduced paperwork and gave real-time data,” he said.

The PPIA is currently functional in 19 wards in Mumbai that have been seeing high occurrences of the disease. The civic body is also in the process of expanding it to all wards across Mumbai.

While the programme has been largely successful, Shah added that the current challenge remains to rope in more private institutions and doctors.

“More doctors have to be aware of the programme and register under the prescribed scheme. Only then can we aim to convert the entire population,” she said.

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