Tuberculosis is one of the world’s deadliest infectious diseases, killing more than 1.4 million people in 2019. More people have died from TB, in the history of mankind, than other infectious diseases like Smallpox, Malaria, Plague, Influenza, Cholera or AIDS. While it’s been well known human disease for millennia the causative agent was not known till 24th March, in1882 when Dr. Robert Koch astounded the scientific community in Berlin,about TB Bacillus (Mycobacterium tuberculosis) as the cause of disease.

TB, unfortunately continues to be the major public health problem in India despite the fact that the National Tuberculosis Control Programme (NTCP) of India was initiated in 1962.

In 1992, the Government of India, together with the World Health Organization (WHO) and Swedish International Development Agency (SIDA), reviewed the national programme and concluded that it suffered from managerial  weakness, inadequate funding, over-reliance on x-ray, non-standard treatment regimens, low rates of treatment completion, and lack of systematic information on treatment outcomes. As a result, a Revised National Tuberculosis Control Programme (RNTCP) was  designed, incorporating the components of the internationally recommended Directly Observed Treatment Short-course (DOTS) strategy for the control of TB. 

RNTCP was implemented in phased manner with nation-wide coverage in March 2006. The spread of Human Immuno-Deficiency Virus (HIV), emergence of various forms of drug resistant TB and unorganised and unregulated vast private sector was recognised to be the main challenges in reducing the disease burden, otherwise as per WHO Global TB report 2019, the incidence of TB reduced from 300/ lakh population in 1990 to 199/lakh population in 2018, and mortality reduced from 76/ lakh population in 1990 to 32 /lakh population in 2018.

Current TB Burden: 

Estimates of TB Burden (2019)




% of Global Burden in India

Incidence TB Cases


2.64 Million


Incidence MDR TB




Mortality of TB(HIV Negative)




Incidence of HIV TB




Mortality of HIV TB




The Government of India has committed to achieve the SDG goal of eliminating Tuberculosis in the country by 2025, five years ahead of the Global Target. In light of this ambitious target and to accelerate momentum towards the ultimate goal, an appropriate and representative change in the name of the programme was imperative, and it was decided to rename the programme as “National Tuberculosis Elimination Program (NTEP)” from Revised National Tuberculosis Control Program (RNTCP), on 1st January, 2020.

Brief Note

Political and administrative commitment, good quality diagnosis, uninterrupted supply of best quality anti TB drugs, treatment under direct observation, robust recording, reporting, supervision, monitoring and evaluation strategy, the five key components of erstwhile RNTCP, better known as DOTS, were aimed to reduce the transmission of TB by early diagnosis and effective treatment of (infectious) sputum positive TB cases.

Under the National Health Mission the diagnostic and treatment services of TB not only expanded manifolds, many newer initiatives were undertaken. TB services now offered to even private sector TB patients, development of Standard for TB Care in India, nutritional support to TB patients, case based TB notification system – NIKSHAY, making the TB notification mandatory from medical practitioners, clinics, hospitals, nursing homes, laboratories,  addressing TB comorbidities, inclusion of anti TB drugs into Schedule-H1 to keep the track of TB patients through sale of anti TB drugs by chemists, are the key interventions towards realization of the goals and objectives set in National Strategic Plan for Tuberculosis:2017-20a25.

New, approach and interventions integrated into the four strategic pillars of “Detect – Treat – Prevent – Build” are aimed to further accelerate the rate of decline of incidence of TB many fold, to more than 10-15% annually.

Vision: TB-Free India with zero deaths, disease and poverty due to TB

Goal: To achieve a rapid decline in burden of TB, morbidity and mortality while working towards elimination of TB in India by 2025.


Find all DS-TB and DRTB cases with an emphasis on reaching TB patients seeking care from private providers and undiagnosed TB in high-risk populations.

Scale-up free, high sensitivity diagnostic tests and algorithms

Scale-up effective private provider engagement approaches

Universal testing for drug-resistant TB 

Systematic screening of high risk populations


Initiate and sustain all patients on appropriate anti-TB treatment wherever they seek care, with patient friendly systems and social support.Prevent the loss of TB cases in the cascade of care:-

Free TB drugs for all TB cases 

Universal daily regimen for TB cases and rapid scale-up of short-course regimens for drug-resistant TB and DST guided               treatment approaches.

Patient-friendly adherence monitoring and social support to sustain TB treatment 

Elimination of catastrophic costs by linking eligible TB patients with social welfare schemes including nutritional support


Prevent the emergence of TB in susceptible populations

•      Scale up air-borne infection control measures at health care facilities 

•      Testing and treatment for latent TB infection in contacts of bacteriologically-confirmed cases and in individuals at high                    risk  of getting TB disease

•       Address social determinants of TB through intersectoral approach


Build and strengthen enabling policies, empowered institutions, human resources with enhanced capacities, and financial resources to match the plan.Translate high level political commitment to action through supportive policy and institutional structures: 

•   National TB Elimination Board with 4 divisions instead of the current administrative set up at the national level and                      matching structures at state level 

•   National TB Policy and Act

•   Restructure RNTCP management structure and implementation arrangement: Substantially augmented HR and HR                      reforms to include unified programme supervisory cadre (merger of STS/STLS/TBHV) and dedicated staff for TB                            surveillance network in the country 

•   Scale up Technical Assistance at national and state levels.

•   Align and harmonize partners’ activities with programme needs to prevent duplication


NTEP is highly technical programme; based on evidences, and guidelines tend to change at shorter intervals. Therefore it is imperative to keep important documents and guidelines accessible to everyone. There is exhaustive list however important ones listed below are available on,

Guideline for Training

i.  Training of Trainers (State level) in Revised Guidelines on Programmatic Management of Drug Resistant Tuberculosis, India (March, 2021), 14-18, June, 2021

ii.  Training of Community Health Officers of Health & Wellness Centre, June, 2021

iii.  Introducing Shorter Oral Bedaquiline containing MDR/RR TB regimen for Drug Resistant Tuberculosis, August 2021

iv.  Introducing TB Preventive Treatment under Joint Effort for Elimination of Tuberculosis (JEET Project) in collaboration with William J Clinton Foundation. September, 2021

v. Engaging Patient Provider Support Agency (PPSA)for improving TB notification and quality of care in private sector. 15 districts, October, 2021

Guidance Document on Community Engagement under National Tuberculosis Elimination Programme   [15383 KB]

Guidelines for Programmatic Management of Tuberculosis Preventive Treatment in India  [12633 KB]

Guidelines for Programmatic Management of Drug Resistant Tuberculosis in India-2021   [47110 KB]

Operational Guidelines for TB services at Health & Wellness Centres   [22142 KB]

Guidelines for use of Delamanid for treatment of DR-TB in India   [3851 KB]

Guidelines on HIV and TB interventions in Prisons and other closed settings - Reg   [4519 KB]

National Framework for a Gender-Responsive approach to TB in India_311219   [2875 KB]

National Strategic Plan 2017-2025 for TB Elimination in India

Guideline for PMDT in India 2017

Technical and Operational Guidelines for TB Control in India 2016


Guidelines for Use of Bedaquiline in RNTCP PMDT in India

Guidelines for Prevention and Management of Adverse Reaction associated to Anti TB drug

Guidelines on Prevention and Management of Tb in PLHIV at ART Centres   [602 KB]

GeneXpert SOP Xpert processing EPTB specimens   [136 KB]

SOP for Extra Pulmonary TB   [301 KB]

PMDT guideline   [7187 KB]

RNTCP Lab Network Guidelines   [592 KB]

SLD storage guidelines   [127 KB]

Operational Handbook on Advocasy Communication and socila mobilization for RNTCP  [7804 KB]

Key Beneficiaries

SL No.




Incentive for referral of presumptive TB patients to public health facility

·         Rs. 500 to informant for referral of presumptive TB patient to public health facility, to    be paid only on diagnosis as TB.


Honorarium to Treatment Supporters:


·         Honorarium to treatment supporter to be disbursed upon completion or cure of TB  patient.

·         Rs. 1000 for Drug Susceptible TB patients

·         Rs. 5000 for Drug Resistant TB patients (including shorter regimen, MDR and XDR TB    patients or as per latest programme guidelines):- Rs. 2000 for I.P. and Rs. 3000 for C.P.

·         Paid only to such workers who are not salaried employees ofthe Central/State              Government. This would include among others Anganwadi workers, trained dais,                  village health guides, community volunteers, ASHA, private providers, private                          chemists, family members etc.


Incentives to Private Providers for notification and reporting of treatment outcome.

·         Rs. 1000 will be provided to Private Providers for notification and reporting of                treatment outcome.

·         lncentives will be given in two instalments:- Rs. 500 at notification and Rs. 500 on                    reporting treatment outcome


Patient support& transportation charges:

·         Patients from tribal / hilly/ difficult areas to be provided an aggregate amount of Rs.    750 to cover travel costs of patient and attendant

·         Travel cost to DR-TB patient to District DR-TB Centre or Nodal DR TB Centre for            diagnosis or follow up as per actual cost per visit through public transport within                    district upto Rs. 400/ visit, outside district upto Rs. 1000/ visit or norms approved by              State Health Society for such visits.


Nutrition Support to all notified TB patients of public & private sector under Nikshay Poshan Yojna

·         Financial incentive to TB patient through DBT for nutritional support, to prevent          catastrophic expenditure andincentivize treatment adherence.

·         Nutrition support at an @ Rs. 500 per month till completion of treatment since              01.04.2018

Events / News

Health data

Annual Report 2020 Public Sector Private Sector Total
Indicators* Target Achievement  Percentage (%) Target Achievement  Percentage (%) Annual Target Achievement Percentage (%)
Notification (% Achievement) 90000 51920 58% 100000 47516 48% 190000 99436 52%
HIV testing (100% of net Notified) 54888 46051 84% 47265 38079 81% 102153 84130 82%
DM testing (100% of net notified) 54888 33681 61% 47265 34297 73% 102153 67978 67%
UDST (82% of net notified) 45008 33602 75% 38757 23730 61% 83765 57332 68%
NPY (eligible patient % paid at least one incentive) 53879 31992 59% 46746 21100 45% 100625 53092 53%
Treatment Success (>90% ) 77326 59455 77% 45652 37403 82% 122798 96858 79%