Imphal, August 25 2010: The slogan 'Together we will free our country from TB speaks volume of the importance of partnering with civil society organisations in improving TB treatment, care and support in Manipur.

Towards this the five-year programme 'Civil Society Initiative to Strengthen TB Care & Control in India' has been launched at Imphal today.

Launching the programme, Ph.

Parijat Singh, Minister of Health & Family Welfare, Government of Manipur, said that this initiative will give a tremendous boost to the existing programme.

"This will help in improving service access for people who are economically backward and resides in remote and hilly areas of the state".

The initiative to strengthen TB treatment, care and support in India comes under a country-wide programme 'Providing Universal Access to Drug-Resistant TB Control Services and Strengthening Civil Society Involvement in TB Care and Control'.

The programme is funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria- Round 9 (GFATM-9) .

Expressing happiness in launching the initiative, Vumlunmang, Commissioner of Health & Family Welfare, Government of Manipur, appealed doctors and civil society representatives to improve referral services in the state.

"While involving the civil society and the community will raise the demand of TB services, we should also cooperate to meet these demands".

The Emmanuel Hospital Association (EHA) will implement the programme in Manipur covering Ukhrul, Chandel, Churachandpur, Bishnupur, Imphal East and West, while the Voluntary Health Association of India (VHAI) will take care of Tamenglong, Senapati and Thoubal over a period of five years starting August 2010.Ukhrul, Chandel, Churachandpur, Bishnupur, Imphal East and West will be covered in the first two year of the programme.

Seeking cooperation from civil society organisations and other stakeholders, Dr.Mathew Santhosh Thomas, Executive Director, EHA, said, "We believe that greater involvement of the community in decision making and implementation of the programme will lead to early diagnosis and treatment of TB in Manipur".

Under the Revised National TB Control Programme (RNTCP) 33,249 new cases of TB have been detected from 2001 to June 2010 in Manipur.

Currently 40, 943 are accessing TB treatment through 52 Designated Microscopy Centres (DMC) and around 500 Direct Observation Treatment (DOT) centres in the state.

Till date 34, 806 TB patients have been treated successfully.

Speaking at the occasion Dr.Ak.

Khamba, State TB Officer, said that the initiative is a boon for people with TB.

"There is a lot to benefit from this programme and this can only be ensured through a coordinated approach, information sharing, and learning from each other's experience".

TB-HIV co infection and cross referral between Integrated Counselling and Testing Centre (ICTC) and RNTCP is another area of concern which requires the same approach to address it effectively.

Since 2008 the Integrated Reference Laboratory (IRL) in Imphal has detected five cases of MDR-TB, the test of which is done at L.R.S.Hospital in New Delhi.

L.R.S.Hospital is one of the four National Reference Laboratories (NRL) in India.

Manipur is yet to provide treatment for MDR-TB which will be made available once the IRL in Imphal becomes fully functional early next year.

The IRL presently supports testing of suspected cases of MDR-TB which cost six to seven thousand rupee for every test.

The programme will support India's Revised National Tuberculosis Control Programme (RNTCP) to expand its reach, visibility and effectiveness, and to engage community-based providers to improve TB services, especially for women, children, marginalised, vulnerable and TB-HIV co-infected populations, by 2015 .

Besides a host of emerging drug-resistant forms of TB (DR-TB) the issue of TB-HIV co-infection and the TB-tobacco nexus need to be addressed by improving access to complete treatment and building awareness across the state- an area where the need for partnership between government, civil society organisations, NGOs and the media becomes apparent.

The civil society will play the unique role of strengthening the engagement of non-programme providers and communities including the community-based ASHAs (Accredited Social Health Activists) and private providers in RNTCP, complementing human resource development, improving access to diagnosis and treatment, increasing commitment to fighting DR-TB and TB-HIV from all levels, and developing cultural sensitive strategies for building awareness.

This will insure improved service delivery in more than 200 underperforming districts and difficult areas like the north-east.

The project hopes to broaden the scope of civil society involvement in TB services through an enduring National Partnership to link RNTCP to other stakeholders through national and state coordination committees.

India bears 21 percent of the global burden of incident TB cases and has the highest estimated incidence of MDR-TB which is 131,000 out of the global incidence of about 500,000 in 2007.Extensively Drug Resistant TB (XDR-TB) has also been reported from India.

HIV prevalence among TB patients is reported to be 4.85 percent.

India's RNTCP, based on DOTS strategy, is being implemented through general health system of the states under the umbrella of National Rural Health mission (NRHM).

The GFATM-9 programme is intended to decrease illness and death due to TB in India and improve access to quality TB care and control services through enhanced civil society participation.

This will be achieved by establishing and enhancing the quality of rapid diagnosis of DR-TB in 43 Culture and DST laboratories in India by 2015, scale-up care and management of DR-TB by initiating treatment of 55,350 additional cases of DR-TB by 2015, improve the reach, visibility and effectiveness of RNTCP through civil society support in 374 districts across 23 states by 2015, and engage communities and community-based care providers in 374 districts across 23 states by 2015 to improve TB care and control, especially for marginalized and vulnerable populations including TB-HIV patients.

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