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AN INDIAN MARRIAGE

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AN INDIAN MARRIAGE

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    1. AN INDIAN MARRIAGE

    2. India is the highest TB burden country accounting for one fifth of the global incidence

    3. MDG Goals: Progress in India Indicator 23: between 1990 and 2015 to halve prevalence of TB disease and deaths due to TB Studies by NTI, TRC suggest annual decline in prevalence by 9%-11%. Mortality rates have declined from 42 per 100,000 population in 1990 to 28 per 100,000 population in 2006 Indicator 24: to detect 70% of new infectious cases and to successfully treat 85% of detected sputum positive patients The global NSP case detection rate is 60% and treatment success rate is 84% RNTCP consistently achieving global bench mark of 85% treatment success rate; and the case detection rate is around 70% (2Q08 – 79%)

    4. Private sector in India

    6. The status of organisation of medical profession in India

    7. IMA National Headquarters New Delhi

    9. RNTCP Guidelines for Private Practitioners’ Involvement Delhi and Kannur models provided evidence for the increase in TB case notification as a result of the involvement of private sector These models helped RNTCP in developing PP guidelines

    10. IMA in 2004 declared nationwide support to RNTCP

    12. Kerala Phase I and II

    13. NSP cases Wayanad 1q 2000-3q 2007-Impact of Private involvement

    14. Kerala

    15. IMA’s strategy for PPM DOTs Profession based approach Non financial incentives One to one peer sensitisation International standards of TB care

    16. Joint Monitoring Mission: Field visit

    17. IMA represented India in the international committee for drafting the International Standards for Tuberculosis Care (ISTC)

    18. IMPACT Indian Medical Professional Associations’ Coalition against Tuberculosis Indian Medical Association National College of Chest Physicians Indian Chest Society Associations of Physicians of India Federation of Family Physicians of India Indian Academy of Paediatrics

    19. ISTC endorsements

    20. IMPACT : formation

    21. IMPACT : formation

    22. IMA-GFATM-RNTCP-PPM PROJECT 2007

    23. Activities… 1 At the National Level Provide leadership and coordinate activities Link with Central TB Division Publish quarterly newsletter on RNTCP/DOTS Insert JIMA article quarterly Reproduce RNTCP IEC material for PPs Print RNTCP Training Module for PPs Report to GFATM through CTD

    24. Activities… 2 At the State Level Provide state-level leadership Link with State TB Cell Handle state & branch-level project expenses Coordinate district-level activities within state Document state & district-level activities Report to IMA National TB Cell

    25. Activities… 3 At the District Level Link with District TB Cell Sensitise IMA members & organise CMEs Identify PPs for involvement in RNTCP Organise training of PPs with DTC Facilitate involvement of PPs in RNTCP Facilitate recognition of PPs as DOTS centres

    26. Progress so far

    27. New schemes published by RNTCP in 2008 for public-private collaborations in TB control in India

    28. Challenges DOT center conversion Sputum transport. Supervision and quality assurance of private sector by Government sector. Referral – feedback mechanisms. Measurement of private sector contribution

    29. My musings Medical profession outside NTP is an asset; not a liability Concerted action by medical profession can result in marked DOTs expansion and substantial reduction in MDR Professional medical societies have a strong role in uniting the profession to fight TB

    30. My musings All PPM in TB is dialogue between clinical medicine and public health. It is as much a political process as technical. ISTC is the knowledge tool which bridges this chiasm. Medical profession transcends the barriers between Government and Private High quality volunteers provide low cost force amplification.

    31. Areas for professional medical societies in TB control Consensus on treatment regimen Consensus on public health duty of clinicians Consensus on notification Consensus on second line drugs Train and maintain a core group of DOTs army

    32. "One small step for a man, one giant leap for mankind."

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