National Strategic Plan to End Tuberculosis in Nepal

National TB Program in Nepal

National TB Control Center (NTCC) is one of the centers within the organizational structure of the Ministry of Health and Population, and is the focal point of National Tuberculosis Programme (NTP). It is responsible for formulating policies, strategies and plans and carrying out monitoring, evaluation and quality assurance of NTP.

The NTP is fully integrated and being implemented within the health system of the Government of Nepal through 135 public hospitals, 2168 non-government organizations, 196 Primary Health Care Centers (PHCCs), 3806 health posts, and 51,420 Female Community Health Volunteers (FCHV) (Annual Report, 2018/19, DoHS).

Why TB National strategic plan (2021/22-2025/26)

Since 1994/95, National TB Program has been formulating short and long-term plans and has been implementing programs accordingly. The TB program has been under implementation in line with the global and national guidance. Since the prevailing strategic plan (2016/17-2020/21) ends in 2020/21, the NTP has formulated the National Strategic Plan to End Tuberculosis in Nepal (2021/22-2025/26) by addressing the topics mentioned below.

• Implement NTP effectively as per the spirit of federalism
• Fulfill the commitments made by the Government of Nepal at the global and regional levels towards meeting the End TB targets.
• Until 2017/18, the number of TB incident cases were expected to be 42,000. However, the results of National Tuberculosis Prevalence Survey carried out in 2018/19 estimates 69,000 new cases of TB, which is 1.6 times higher than previously estimated. Therefore, it is of utmost importance to utilize more effective technology for the diagnosis of TB in order to end TB.

• In the process of formulating this strategic plan, extensive country level dialogue and discussions have been conducted with the experts, different groups and policymakers from the local to the central level by forming Technical Advisory Committee and various other committees on different dates. This strategic plan has included the suggestions received from such in-depth discussions along with the recommendations received from the joint programme monitoring and evaluation carried out by national and international experts in 2018/2019.
• This strategic plan has been developed to be used as a policy to guide the provincial and local level governments as well. The role and responsibilities of the federal, provincial and local levels are described in Section 5.

Vision

• TB free Nepal

Goal

• Nepal has set a goal to decrease incidence rate from 238 in 2020/21 to 81 patients per 100,000 population by 2025/26; decrease mortality rate from 58 in 2020/21 to 23 per 100,000 by 2020/21; end TB by 2035; prevent TB by 2050; and reduce the catastrophic cost to zero.

Objective

1. To build and strengthen political commitment, sustainability and patient-friendly health system to end TB.
2. To ensure the identification of TB, diagnosis, quality treatment and prevention.

Strategies

• Improve the quality of TB services and strengthen the health system for universal access to TB services; effectuate the TB services and support by increasing the community engagement in TB management, and strengthen the digitalized case-based surveillance system in health care facilities.
• Strengthen laboratory services to further improve the management of TB diagnosis and treatment.
• Quality Improvement of the services for TB prevention, identification and Treatment.

Recommended readings

• GLOBAL TUBERCULOSIS REPORT 2021
• Global Tuberculosis Report 2020
• Global Tuberculosis Report 2019: Latest status of the tuberculosis epidemic
• Global Tuberculosis Report 2018
• WHO Global Tuberculosis report 2015
• Global tuberculosis report 2014: Improved data reveals higher global burden of tuberculosis
• National Tuberculosis Programme Annual Report 2018
• National Tuberculosis Program Update in Nepal #WorldTBDay #EndTB
• National TB Prevalence Survey, 2018-19 Key findings
• World Tuberculosis Day 2020! It’s time to End TB!
• National Guideline on Drug Resistant TB Management 2019, Nepal
• National Tuberculosis Management Guideline 2019, Nepal
• Global Tuberculosis Report 2019: Latest status of the tuberculosis epidemic
• National TB Prevalence Survey, 2018-19 Key findings
• New WHO recommendations to prevent tuberculosis aim to save millions of lives
• World Health Organization (WHO) Information Note Tuberculosis and COVID-19
• World Tuberculosis Day 2020! It’s time to End TB!
• People-centred framework for tuberculosis programme planning and prioritization, User guide
• Global Tuberculosis Report 2019: Latest status of the tuberculosis epidemic
• Dissemination of Findings and Recommendations of Joint External Monitoring Mission(JEMM) of Nepal National Tuberculosis Program
• National Tuberculosis Programme Annual Report 2018
• National Strategic Plan for Tuberculosis Prevention, Care and Control 2016 – 2021
• NTP, Nepal: New TB Treatment Algorithm & Regimen (Updated)
• WHO announces landmark changes in MDR-TB treatment regimens
• TB Vaccine results announce a promising step towards ending the emergency
• 7 million people receive record levels of lifesaving TB treatment but 3 million still miss out