National PMDT Scale-up Plan - India - 2011-12 - TBC India

National Scale up Plan for Programmatic Management of DR TB 2011 - 2012
supported by the EXPAND TB project (WHO GLI, UNITAID and FIND); Global Fund (RCC & Round 9),
World Bank and USAID through WHO for the National Laboratory Scale up plan for 43 LPA and 33 Liquid
Culture units to provide an incremental capacity by 2014 of approximately > 160000 DSTs and > 220000
follow-up cultures. These 43 labs include the NRLs, all IRLs and selected Medical College Laboratories
from across the country. Liquid Culture DST for first line anti-TB drugs is available to the RNTCP through
some of the private and corporate providers (NGO PP scheme for C and DST) like Hinduja hospital that is
providing services for Mumbai City. In addition, these schemes will be extended to other areas with
additional private laboratories like Quest and Super Religare from 2011-12 onwards.
FIND has also supported in establishing a National Training Centre (International Centre for Excellence in
laboratory training) in the premises of the National Tuberculosis Institute, Bangalore which is one of the
National Reference Laboratories of India. The training center will cater to the recurrent training needs of
the laboratory staff that will man the 43 LPA and 33 liquid culture units to be established by 2014. The
infrastructure up gradation that is required for the introduction of newer tools is also being supported
by PATH which is upgrading 15 labs for LPA and 8 labs for BSL III facility.
RNTCP has also mobilized support for the procurement of second line anti-TB drugs from GF (RCC and
R9 to support the treatment of additional 12,650 and 55,350 MDR-TB patients respectively in 2010-
2015) and UNITAID (under the MDR-TB Scale-up Initiative for the treatment of an additional 9,850 MDR-
TB patients between 2010/11-2011/12). The resources for procurement of second line drugs are
summarized in the table below:
Table 5: Resources for procurement of second line drugs with timelines
Source 2010-11 2011-12 2012-13 2013-14 2014-15
Global Fund –RCC 800 1200 2450 3500 4250
World Bank 2350 3450 4550 9000 13250
UNITAID 4850 5000 - - -
Global Fund Rd 9 - 5350 18000 17500 14500
Total 8000 15000 25000 30000 32000
Procurement through GLC 5650
(70%)
14
11550
(77%)
20450
(82%)
21000
(70%)
18750
(60%)
With the support of Global Drug Facility, the first meeting with Indian Drug Manufacturers was held in
Delhi in Feb 2011 to advocate with them to adopt and adhere to the WHO Pre-Qualification Standards
and GDF Quality Assurance Systems. The national scale up plan and volumes of drug courses planned to
be procured by India were shared with the Indian drug manufacturers and they were encouraged to
enhance their manufacturing capacities and quality standards for production of the Second Line Drugs.
4.4. Engaging with all health care providers and civil society partners
RNTCP has made progress towards establishing successful partnership with private sector, nongovernment
organizations, medical colleges and civil society partners under PMDT in providing services
to MDR TB cases in the implementing states. As on December 2010, 7 Culture and DST laboratories from