National Tuberculosis Elimination Program Guidelines and its Relevance to the Indian Population in the Post-COVID-19 Pandemic Era

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Sriram Krishnamoorthy, MS, MCh, DNB, FRCS (Glasgow) Kalpana Ramachandran, MS, DNB, FRCS (Glasgow)



Introduction: Though tuberculosis was declared a public health emergency in 1993 and the revised national tuberculosis control programme gained momentum soon after, south Asian countries were left with a daunting task in the effective implementation of the control measures. The decades of progress achieved in tuberculosis control and elimination measures were almost wiped off in the last 12 to 18 months of the COVID-19 pandemic, clearly indicating that these measures need to be more structured and resilient. This manuscript focuses on the impact of the COVID-19 pandemic on TB control and also on the measures taken by the Government of India in effectively combating this syndemic.

Tuberculosis and COVID – a synergistic syndemic: The positive trends in tuberculosis elimination strategies observed till 2019 showed a dramatic reversal after the onset of the COVID-19 pandemic. The sharp decline observed in the TB notification rates in 2020 and 2021 showed signs of improvement in the first two quarters of 2022. Biological interactions between tuberculosis and COVID-19 agents, lung parenchymal damage occurring in both diseases, multiple lockdowns, the reduced workforce at tuberculosis notification centres and reallocation of funds to control the new-onset pandemic were some of the reasons for the decline in overall notifications across the globe.

Government goals (post-syndemic) and measures: The National Tuberculosis Elimination Programme initiated a holistic approach to eliminate TB from South Asia by 2030. Innovative strategies like digitalization of service delivery systems, telemedicine consultations and a four-tier hierarchy system resulted in a rise in the number of tuberculosis notifications. Making this campaign a public movement, creating Public Support Groups and propagating an online Nikshay portal for tuberculous notification greatly facilitated efforts to create a tuberculosis-free world.

Conclusions: Despite the COVID-19 pandemic causing a temporary slowdown in the measures to eliminate tuberculosis by 2030, digitalization processes and various innovative strategies have kept disease elimination hopes still alive. The government alone may not be able to accomplish this goal. Combined efforts and collective responsibility from the public, medical and para-medical support staff are imperative in making this dream of a tuberculosis free society, soon a reality.

Keywords: RNTCP, tuberculosis, COVID-19, pandemic, syndemic

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How to Cite
KRISHNAMOORTHY, Sriram; RAMACHANDRAN, Kalpana. National Tuberculosis Elimination Program Guidelines and its Relevance to the Indian Population in the Post-COVID-19 Pandemic Era. Medical Research Archives, [S.l.], v. 10, n. 12, dec. 2022. ISSN 2375-1924. Available at: <>. Date accessed: 17 june 2024. doi:
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