The budget for the National Strategic Plan to eliminate tuberculosis by 2025 has been pared down from over Rs 16,000 crore to Rs 12,000 crore in the proposal sent to the Prime Minster’s Office for final approval. The plan document in the public domain envisaged a spending of Rs 16,600 crore and before that the government started with the figure of Rs 19,000, said sources in the health ministry.

However, the document that has recently been sent to the PMO for final approval deals with a budget of about Rs 12,000 crore, according to highly placed sources in the health ministry.

The plan proposes greater and better incentivised engagement with the private sector that treats the bulk of TB cases, availability of rapid molecular tests, SMS service to ensure better patient compliance and the setting up of a Bharat Kshay Niyantran Pratishthan (India TB Control Foundation) for activities such as nutrition support to TB patients, active case finding in prisons, slums, tribal areas, sputum collection and transport.

A national level annual review of the programme will be undertaken by the TB elimination board chaired by the PMO.

“Significant increase in the budget allocation for the financial year 2017-2018 and beyond will be required to implement the NSP,” read the National Strategic Plan document for TB elimination 2017-2025.

The document added that “the resource requirements for implementing the NSP will be a function of the pace of implementation of the strategy, the demand from states and the availability of resources in an environment of significant ( percentage over the last 2 NSP periods) growth in the overall programme budget. Hence advocacy with national government and resource generation strategies will be aggressively pursued. It is expected that the cost of implementing the new NSP at Rs 16,649 crore ($2,485 million) will involve a significant increase over the last NSP budget.”

However, at the stage of finalisation of the budgetary provision, health ministry sources said, it was thought to be way more than what the states are currently in a position to spend in the designated period.

“We had started with a figure of Rs 19,000 crore but the draft that has now been sent to the PM for his approval is looking at a spending of about Rs 12,000 crore. That is realistic,” said a senior health ministry official.

TB kills an estimated 480,000 Indians every year and more than 1,400 people every day.

India also has more than a million “missing” cases every year that are not notified and most remain either undiagnosed or unaccountable and inadequately diagnosed and treated in the private sector.

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