Peer Driven Approach in Hiv-Tb Programme

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National Framework For Joint TB/HIV Collaborative Activities October 2009

National AIDS Control Organization And Central TB Division Ministry of Health & Family Welfare Government of India New Delhi

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Acknowledgement
The National Framework has been prepared jointly by National AIDS Control Organization and Central TB Division, DGHS for the training of programme managers under the guidance of Dr. Damodar Bachani, DDG, NACO and Dr L. S .Chauhan, DDG (TB) CTD, DGHS by a writing group comprising of Dr. Devesh Gupta, Dr. Puneet Dewan, Dr. Rahul Thakur, Dr. Raveendra Reddy, Dr. Ajay Kumar, Dr. Malik Parmar and Dr. Vartika Sharma.

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NATIONAL FRAMEWORK FOR JOINT TB/HIV COLLABORATIVE ACTIVITIES (OCTOBER 2009) INTRODUCTION As per NACO sentinel surveillance report of 2007, the prevalence of HIV infection is estimated to be 0.34 % of the population, which translates to 2.31 million people living with HIV/AIDS in India. Tuberculosis (TB) continues to be a public health challenge in India and is estimated that 1.9 million new cases of TB occur in India annually. Active TB disease is the commonest opportunistic infection amongst HIV-infected individuals. High-quality diagnosis and treatment for TB is provided nationwide under the Revised National TB Control Programme (RNTCP). RNTCP anti-TB regimens have been shown to be effective in TB patients with or without HIV infection. TB-HIV collaborative activities between RNTCP and NACP started initially in the year 2001, in the six states with high prevalence of HIV/AIDS i.e. Andhra Pradesh, Karnataka, Maharashtra, Manipur, Nagaland and Tamil Nadu. The collaborative activities were extended to 8 additional states in 2004. The National Framework for Joint TB/HIV Collaborative Activities was first developed in 2007, with a revision in February 2008. The 2007-2008 National Framework extended basic TB-HIV activities nationwide. An intensified TB/HIV package of services was developed to offer additional services in States with the higher burden of HIV-TB. This 2009 revision of the National Framework establishes uniform activities at ART centres and ICTCs nationwide for intensified TB case finding and reporting, strengthens joint monitoring and evaluation with specified national TB/HIV programme indicators and performance targets. The overall purpose of the National framework is to articulate the policy for strengthening TB/HIV collaborative activities between RNTCP and NACP, resulting in reduction of TB and HIV burden in India. OBJECTIVES: 1. To strengthen the mechanisms for coordination between RNTCP and NACP at National, State and District levels. 2. To decrease morbidity and mortality due to tuberculosis among persons living with HIV/AIDS. 3. To decrease the impact of HIV in tuberculosis patients and provide access to HIV related care and support to HIV- infected TB patients

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SPECIFIC TB/HIV COLLABORATIVE ACTIVITIES
1. Establish / Strengthen NACP-RNTCP coordination mechanisms at national, state and district level. 2. Scaling up of Intensified TB/HIV Package of Services across the country. 3. Joint Monitoring and Evaluation including standardized reporting shared between the two programmes. 4. Training of the programme and field staff on TB/HIV 5. TB and HIV service delivery coordination 5.1. Offer of HIV testing to TB patients 5.2. Intensified TB case finding at ICTCs, ART and Community Care Centres 5.3. Linking of HIV-infected TB patients to NACP for HIV care and support ( including antiretroviral treatment) and to RNTCP for TB treatment 5.4. Provision of Cotrimoxazole Prophylactic Treatment (CPT) for HIV-infected TB patients 6. Implementation of feasible and effective infection control measures 7. Involvement of NGOs/CBOs and affected communities working with NACP and RNTCP for all activities on TB/HIV collaboration. 8. Operational research to improve the implementation and impact of TB/HIV collaborative activities.

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1. NACP-RNTCP COORDINATION MECHANISMS...
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