It will have to focus more on strengthening diagnostic services and training component

The sixth Joint Monitoring Mission (JMM 2019) of the Union government and the World Health Organization on the Revised National Tuberculosis Control Programme (RNTCP) has lauded Kerala for being right on track to achieve TB elimination by 2025.

However, the last mile is the toughest and as Kerala moves on to TB elimination, the State will now have to focus better on strengthening its diagnostic services and the training component so that every case in the community is picked up.

Hence more molecular diagnostic services (CBNAAT /Genexpert machines) are needed, the JMM team, which met the Health Minister and the Principal Secretary here on Saturday, suggests.

The last time a JMM visited Kerala was in 2002. The sixth JMM, comprising 24 members, is visiting Kerala as part of the mid-year assessment of India’s National Strategic Plan for TB Elimination, 2017-25.

Positive approach

“The seamless integration of the RNTCP with the State’s health system and the manner in which every health worker is owning the programme is something that I have not witnessed elsewhere,” Amy Piatek, Senior TB Technical Adviser, US Agency for International Development (USAID), and JMM team leader, told The Hindu.

Challenges ahead

“True commitment -- from programme implementers as well as administration -– is what we witnessed in Kerala. There are challenges ahead because the last cases are the hardest to find. What you need to do is continue to look at the data on hand critically and focus on epidemiology, “ Ms. Piatek added.

The JMM team felt that the State has allowed its Intermediate Reference Laboratory (IRL) in the capital (where advanced tests are done) to languish and that very little has been done to improve the technical capacity or human resource.

Ms. Piatek was all praise for how Kerala has engaged with the private sector and has been working in partnership with private sector physicians so that every case is notified, treated and followed-up.

“The involvement of the local bodies bodies in the RNTCP and TB Elimination Mission is another plus that is unique to Kerala. In many panchayats, we found the leadership has been the driver of change,” she said.

Apart from Thiruvananthapuram, the JMM team has been touring Thrissur and Wayanad districts all of this week, interacting with programme managers, health workers, patients and their families.