The hundreds of homeless who sleep on the pavements of Chandni Chowk and the platforms of Old Delhi Railway Station do not have a home address, but they receive housecalls from doctors.
A doctor, a senior treatment supervisor and a laboratory technician visit them every Monday, Wednesday and Friday mornings to screen them for tuberculosis and give them free TB medicine under medical supervision under the government's Revised National TB Control Programme (RNTCP).
Prem Neelkanth’s food stall in a Mumbai slum also doubles as a TB clinic. Every day, Neelkanth dispenses free TB pills from the neat row of medicine boxes marked with the patients’ names.
The Ramakrishna Mission at Belur Math in Howrah district of West Bengal is also an active partner in the government’s RNTCP since November 2003. It doubles as a microscopy and treatment centre in partnership with the TL Jaiswal Hospital TB Unit in Howrah.
Two people die of TB every three minutes in India, but these statistics are headed to change for the better. Public-private partnerships between the government and individuals, private doctors, NGOs, industry and corporate houses have made India’s RNTCP among the most successful public health programme in the world.
“The RNTCP has saved over one million lives and now India is exporting many of the lessons learned here on how to deal with underprivileged populations and how to help those who cannot help themselves,” says Salim J Habayeb, India Representative, World Health Organisation, at the end of a joint monitoring of the RNTCP by a panel of international experts.
Over the last two weeks, international experts visited 20 randomly selected districts in six states — Gujarat, Haryana, Karnataka, Madhya Pradesh, Punjab and West Bengal — to review patient records and interview patients at government-run TB clinics. They all had good things to say. “The overall progress in TB control is exceptional. The private sector has a shared role in giving the government’s free drugs to patients and reporting their progress to the RNTCP,” said Dr J Narain, a WHO expert.
Under the RNTCP, free TB medicines are given under direct supervision (called directly observed treatent short-course or DOTS) for two to three months to ensure patients adhere to the prescription course and do not develop multidrug-resistant (MDR) TB, which is expensive and sometimes impossible to cure.