Himachal Pradesh’s declaration less more or eradicate Tuberculosis by 2021 seems a distant dream, given the stumbling blocks in effective implementation of Revised National Tuberculosis Control Programme (RNTCP) in the hill state.
While the toughest terrain across majority districts in HP is a regular hurdle in reaching people for awareness, detection and treatment compliance of the communicable disease, the alleged ‘rigid mindset’ of policy makers in letting the things happen on ground too hampers success.
Official records say 14,500 fresh cases of TB are registered on an average annually in government health institutions in HP. The number may go up to 20,000 at a point of time if private clinics are also included.
Two hundred and fifty cases of Multi Drug Resistant (MDR) TB were reported in 2016. There were over 500 TB deaths in HP last year.
Eight of 12 districts of HP formed part of the top 30 districts of country, which had high annual TB case notification rate (more than 180 new TB cases per lakh population per year) as per 2015 data.
Sources said that the RNTCP does have contractual staff lined up in field, but it is mostly demoralised for not having been given revised scales in tune with central guidelines for past over three years, despite repeated requests by them.
Sources said HP is one of the few states in India, which has not implemented the salary structure approved by Government of India for TB control staff. And that’s why the RNTCP is grappling with shortage of Medical Officers (MOs) too, who are an important link up in meeting the complex procedures in programme, which involves hectic monitoring.
Sources said that seven posts of Medical officers under RNTCP were advertised on 25 November, 2016 by the National Health Mission (NHM) in HP, but no MBBS doctor applied for the posts, deadline for which closed on 25 Dec 2016. The reason: The state government offers them salary of Rs 26,250 per month against Rs 36,364 per month fixed by the Central TB Division of Government of India.
Mission Director of NHM, Hans Raj Sharma, however, told The Statesman that the Medical Officers in the RNTCP are being given a salary at par with those recruited by state government. “It is the government’s decision. We will discuss it again if there are no applicants for job.” The doctors, however, reject it as they say the MOs recruited by the state government are given financial incentives over and above salary, and their service is counted for Post Graduation and regularisation. “In RNTCP, we just get the salary.”
The TB experts say the training of doctors in TB management are highly skilled task and lack of key persons in place will dent the ambitious efforts to eradicate TB.