Medical College Task Force Workshop on NTEP

1. National Workshop for Medical Colleges Task Force to
Accelerate Ending TB in India
Revised Standard Operating Procedures (SOPs)
and scope of activities in Medical Colleges
Dr. Ashok Bhardwaj
NTF Chairman (NTEP)

2. Medical College should be
committed to:
1. Provide best Teaching and Training;
2. Provide Best Patient care;
3. Provide Point of Care (POC) Health services for the
Community;
4. Provide management support to State Health Services; and
5. Undertake Operational Research for the Benefit of the
Programme and the Society.

3. Medical Colleges Collaboration
NTF
ZTF
STF
Core Committee
Microscopy
Centre
DOT Centre
Training
Research
Tertiary level TB
Case Management
DR-TB services
 Human Resource
 Referral Feedback system
 Monitoring
 Linkages for diagnosis and
treatment
> 647 Medical
Colleges
(NMC)

4. What NSP 2017-25 envisaged for Medical Colleges
1. Core Committee will ensure the implementation of NTEP activities in
Medical College.
2. The STF will facilitate est. of DMCs, DOT centers, DRTB Centers and
Molecular labs in all MCs in the respective states.
3. The ZTF will facilitate the functioning and monitoring of STF, and
coordinate between the NTF and STF.
4. The NTF will recommend policy suggestion and monitor the activities of
the ZTF.

5. Activities for Medical Colleges
Diagnostic & Treatment Services
Decentralized DR-TB
Services
Culture DST support
Active Drug Safety
monitoring
Saturation of TPT
Tele-radiology services
Air borne infection control
measures
Other Services
Planning, surveillance & quality improvement
support
Sub-National TB Free Certification
Private provider engagement
TPT Implementation
Active Case Finding
Intensified Case Finding
Operational Research

6. Scope of activities - 1
1. Engagement : establishment of DMC & DOT
center / DRTB Centre/C & DST Labs/ IRLs/ CoE)
2. Service delivery
• Diagnosis of TB ( DSTB/DRTB )
• Treatment of TB (DSTB/DRTB)
• TB Preventive Treatment
3. Advocacy
4. Capacity building (training /sensitization)
5. Decentralized Drug Resistant TB Services*
6. Culture Service Support
7. Establishment of CoEs
8. ADR Management (aDSM)
9. Tele-Radiology-promote telemedicine and
teleradiology
10. Air Borne Infection Control measures
11. Planning, Surveillance & Quality
Improvement**
12. TPT Implementation
13. Private Provider Engagement
14. Active Case Finding (ACF)
15. Intensified case finding (ICF)
16. Sub-National TB Free Certification
17. Operational Research
* Decentralized DR TB Services
•Pre-treatment evaluation.
•Management of severe adverse drug reactions.
•Management of complicated DR-TB patients.
•Indoor services.
•Capacity building of NTEP team.
•PP Sensitization.
** Planning, surveillance and quality improvement support to
districts:
•Faculties of Medical Colleges will be involved in planning of NTEP
services and subsequent monitoring and evaluation.
•The department of Com Med will be involved in monitoring and
surveillance of disease including carrying out local surveys.
•For quality assurance of laboratory services, the department of
Microbiology will be involved and appropriate capacity
enhancement will be done.

7. Scope of activities - 2
• Public health actions
1. Support in Planning of Services
2. Surveillance
3. Quality Improvement
4. Local Surveys
5. Supportive supervision
6. Monitoring & Evaluation
7. Adopt district for interventions
Demonstrate TB Free in field practice areas (RHTC, UHTC)

8. Engagement of Private Providers
Medical colleges should support
1. Peer education and sensitization of Private Providers;
2. Dissemination of diagnostic & treatment practices;
3. Advocacy with professional associations.

9. DR-TB Services in Medical College
• In view of availability of expertise in medical
colleges, there is a felt need to leverage on
their strength to improve clinical, adverse drug
reactions (ADRs) and co-morbidity
management of DR-TB patients across India for
enhancing quality of care, treatment success
and survival of these difficult to treat patients.
• National Medical Commission (NMC) issued a
Gazette notification in October 2020 mandating
all Medical Colleges to establish a facility for
management of DR-TB by the time of 3rd
renewal (admission of 4th batch of MBBS
students)

10. Situational Analysis of Task Force Arrangement
Strength Weakness
• One forth of TB patients are diagnosed.
• Difficult to diagnose case like EP-TB, Pediatric
TB.
• Management of DR-TB.
• Technical Experts for Clinical Services of
Programme.
• Under notification; specially other than chest
department.
• Low results from research mechanisms.
• Limited contribution to bring PP on board.
Opportunity Threat
• Beyond Medical Colleges.
• Surveillance.
• Public health Measures.
• Capacity building of health system.
• Limited involvement of other departments.
• Management of coordination issues at local
/state level.
• Availability of Funds.

11. Beyond Medical Colleges…
• Active Case Finding;
• High Risk Population – mapping and mainstreaming;
• Operational Research to support program management;
• Capacity Building of field staff;
• Supportive Supervision;
• Monitoring and Evaluation;
• Model program – RHTC/ UHTC field practice area.

12. • NTF
• ZTF
• STF
• Core Committee

13. SOP for State Task Force - 1
1.Constitution of STF
• The committee has one Chairperson and one Nodal Officer who will also be the
coordinator for NTEP .
• Following will be the office bearers & members of the committee:
• Chairman/Vice Chair: Senior Professor (Any Medical College in the State) or Prof/Addl. Prof.
(Institute of National Importance in the State) of Pulmonary Medicine
Community Medicine/ General Medicine/ Microbiology*
The State Task Force needs to nominate Vice-Chair/s, (One Vice-Chair for 10 Med Colleges)
* Director Medical Education cannot chair the NTEP-STF committee.
• Member Secretary : State TB Officer (STO).

14. SOP for State Task Force - 2
• State OR Chairman : Senior Professor (Any Medical College in the State)
or Prof/Addl. Prof. (Institute of National Importance
in the State) of Pulmonary Medicine/ Community
Medicine/ General Medicine/ Microbiology
• Member Secretary : State TB Officer (STO).
• STF Coordinator : STF chairman will nominate one STF coordinator to
coordinate activities amongst all
Medical College of the State
2.Constitution of STF OR Committee

15. Medical College Task Force Mechanism
State Task Force
• Chairperson
• Vice chair
• Member secretary
• Nodal Officers
• STF Coordinator
• Representatives of
the related
departments
Senior Professor (Any Medical College in the State) or Prof/Addl.
Prof. (Institute of National Importance in the State) of Pulmonary
Medicine/ Community Medicine/ General Medicine/ Microbiology*
State TB Officer of the state
From Pulmonary Medicine/ General Medicine/
Community Medicine
STF chairman will nominate one STF coordinator to
coordinate activities amongst all Med Colleges of the State
General Medicine /Pulmonary Medicine /Community Medicine /Surgery/
Microbiology /Pharmacology /Pediatrics /Orthopedics /OBGY/ENT /Pathology
/Biochemistry / Co-opt any members committee feels
Special invitees: NTF/ZTF Chair/Chair state OR Committee WHO Consultant/

16. SOP for State Task Force - 3
1. To be elected as a STF Chair/Vice Chair or State OR Chair,
• the person should at least be an existing member of MCCC from any of the Medical Colleges of the state &
should have an overall association with the Task Force mechanism for a minimum period of 4 years.
2. There is no fix tenure for the post of Member Secretary as it is ex-officio.
• Chairman/Vice Chairman of STF, State OR Chairman & all other members including Coordinators & Nodal
officers will have a tenure of three (2) years which can be extended only once for a maximum of another
tenure of 2 years. At the end of their respective tenure, new office bearers & members will have to be
replaced representing different Medical Colleges of the State by either election or by selecting unanimously.
3. Office bearers (Chairman/Vice Chairman, State OR Chairman) of STF cannot hold dual charges simultaneously as
Office bearers (Chairman/Vice Chairman, OR Chairman) at either the Zonal or National level of this Task Force
mechanism of NTEP. This can be permitted in exceptional circumstances. No office bearers or members can hold
the office after retirement/resignation or if no longer employed/associated with any Medical Colleges of that state.
However this does not apply to anyone who after retirement/resignation is employed in any Medical College of
the same state in any capacity.
4. Office bearers (Chairman/Vice Chairman, State OR Chairman) of STF should be willing to spare time for the cause
of Task Force activities.
Tenure with other terms & conditions

17. SOP for State Task Force - 3
1. To be elected as a STF Chair/Vice Chair or State OR Chair,
• the person should at least be an existing member of MCCC from any of the Medical Colleges of the state &
should have an overall association with the Task Force mechanism for a minimum period of 4 years.
2. There is no fix tenure for the post of Member Secretary as it is ex-officio.
• Chairman/Vice Chairman of STF, State OR Chairman & all other members including Coordinators & Nodal
officers will have a tenure of three (2) years which can be extended only once for a maximum of another
tenure of 2 years. At the end of their respective tenure, new office bearers & members will have to be
replaced representing different Medical Colleges of the State by either election or by selecting unanimously.
3. Office bearers (Chairman/Vice Chairman, State OR Chairman) of STF cannot hold dual charges simultaneously as
Office bearers (Chairman/Vice Chairman, OR Chairman) at either the Zonal or National level of this Task Force
mechanism of NTEP. This can be permitted in exceptional circumstances. No office bearers or members can hold
the office after retirement/resignation or if no longer employed/associated with any Medical Colleges of that state.
However this does not apply to anyone who after retirement/resignation is employed in any Medical College of
the same state in any capacity.
4. Office bearers (Chairman/Vice Chairman, State OR Chairman) of STF should be willing to spare time for the cause
of Task Force activities.
Tenure with other terms & conditions

18. SOP for State Task Force - 4
• Election of the STF chair
STF chairman will be elected by all members of the STF. Members can decide about the 2nd
tenure to the incumbent or the new chairman of the State Task Force. There should be at
least 50% members present to elect the new chairman or to grant another tenure.
The notice for election has to be at least 15 days in advance and will be done in STF
meeting.
• Election of the STF OR chairman
STF OR chairman will be elected by all members of the STF. Members can decide about the
2nd tenure to the incumbent or the new chairman of the State Task Force. There should
be at least 50% members present to elect the new chairman or to grant another tenure.
Tenure with other terms & conditions
STF chairman and STF OR chairman cannot be from the same specialty.
STF chairman and STF OR chairman cannot be from the same Institution

19. SOP for State Task Force - 5
Functions of State Task Force
1. Review the performance of different Medical Colleges in the State.
2. Submit a quarterly STF report to the STO, ZTF, NTF, and CTD.
3. Hold a quarterly review meeting of the STF to review the performance of
the NTEP activities in the Medical Colleges of the state and share the
minutes of the same with the ZTF/NTF Chair/vice-chair.
4. Training of Medical College faculty/ staff, which include Training of the
faculty coordinator in Trainer of trainers, Master trainers (MO TC
modular training at state/national level).
5. Organize CMEs/ Conference on NTEP.
6. Ensure that teaching on TB/NTEP form part of curriculum for PG
students/ Residents / Interns/ UG students.

20. SOP for State Task Force - 6
Functions of State Task Force
7. Coordinate with the STO for participation in the quality assurance network
of sputum microscopy, referral for treatment network, management of
complicated cases of TB.
8. Organize capacity-building workshops for Operational Research in the
state.
9. Undertake OR/ PG thesis for NTEP on the priority areas defined by the STF
for the State in consultation with STO.
10.State OR Chairman to take responsibilities to approve/sanction the ORs
within the budget limit of Rs 2 lakh and Rs 30000/ thesis; OR between 2-5
lakhs will be referred to ZTF OR.
11.Support State TB Officer in
• planning & organizing Difficult To Treat TB Cases Clinics (D3C Clinics)
fortnightly and for preparation of annual PIP of Medical Colleges

21. SOP for State Task Force - 7
Meetings:
State STF Committee
•The STF will meet quarterly and will discuss various issues related to the
implementation of NTEP in the Medical Colleges including approval/ sanction
of Operational Research projects/PG thesis as approved by the State OR
Committee.
• Fund for STF meetings should be provided by the State TB Cell.
State STF-OR Committee
• The STF-OR committee will meet twice in a year during routine STF
meetings and will discuss and approve Operational Research
projects/PG thesis received by the committee.
• The committee will recommend to STF regarding approval/sanction of
Operational Research projects/PG thesis.

22. SOP for State Task Force - 8
1. Review of Performance of the Medical Colleges based on the latest
available Medical College quarterly report and other relevant documents -
to be presented by the Nodal Officer (Public Health) of the respective
Medical College.
2. Discussion for Organization of CME and other sensitization programmes
for Private Practioners.
3. Discuss issues related to different Medical College.
4. Sanction and approve Thesis for PG students/Sanction and approve OR
projects – STO to finance.
5. Review the status of any ongoing PG thesis or Operation Research
projects in the State.
6. Support STO in ACF and other activities.
7. Any specific issue related to a Medical College that cannot be resolved in
Medical College Core Committee.
Check list for Quarterly Meetings of STF

23. SOP for State Task Force - 9
Responsibilities of Chairman STF
1. STF chair will be responsible for organizing quarterly STF meetings in
consultation of State TB Officer.
2. STF chair will prepare the Minutes of Meeting with support from STF
coordinator.
3. STF chair will share MOM with ZTF, NTF, CTD and all the participants of
the meeting.
4. STF chair will ensure that funds are released to the Principal
Investigators of the OR projects & the Thesis by the STC.

24. SOP for State Task Force - 9
Responsibilities of Chairman STF
1. STF chair will be responsible for organizing quarterly STF meetings in
consultation of State TB Officer.
2. STF chair will prepare the Minutes of Meeting with support from STF
coordinator.
3. STF chair will share MOM with ZTF, NTF, CTD and all the participants of
the meeting.
4. STF chair will ensure that funds are released to the Principal
Investigators of the OR projects & the Thesis by the STC.

25. Zonal Task Force
Constitution of ZTF
There will be a Zonal Task Force for 6 zones in the country
1. North Zone
2. North East Zone
3. East Zone
4. West Zone
5. South-1 Zone
6. South-2 Zone

26. SOP for Zonal Task Force - 1
• The committee has one Chairperson/ one or more Vice Chairs and one
Zonal OR Chair/ Vice chair.
• Following will be the office bearers & members of the committee:
Chairman/Vice Chair : Senior Professor (Any Medical College of the same
Zone) or Prof/ Addl. Prof. (Institute of National
Importance in the same Zone) of Pul Med/ Com
Med/ Gen Med /Microbiology
Member Secretary : State TB Officer (STO) of the State where ZTF
chairman is placed.
Members of ZTF : All the STF Chairman/Vice Chairs of respective
states of the Zone
Constitution of ZTF

27. SOP for Zonal Task Force - 2
Zonal OR Chairman : Senior Professor (Any Medical College of the Zone)
or Prof/Addl. Prof. (Institute of National
Importance in the Zone) of Pulmonary Medicine/
Community Med / General Medicine/ Microbiology
Member Secretary : State TB Officer (STO) of the State where ZTF OR
chairman is placed.
Members Zonal OR : All the State OR Committee Chairman/ Vice Chairs
of respective states of the Zone.
ZTF Coordinator : ZTF chairman will nominate one coordinator to
coordinate NTEP activities amongst all State in the
zone.
Constitution of ZTF OR

28. Medical College Task Force Mechanism
Zonal Task Force
• Chairperson/Vice
Chair
• Member secretary
• Members of ZTF
• ZTF Coordinator
Senior Professor (Any Medical College of the same Zone) or
Prof/Addl. Prof. (Institute of National Importance in the same
Zone) of Pulmonary Medicine/ Community Medicine/ General
Medicine/ Microbiology
State TB Officer (STO) of the State where ZTF Chair is placed
STF chairman will nominate one STF coordinator to
coordinate activities amongst all States of the Zone.
All the STF Chairman/Vice Chairs of respective states of
the Zone

29. SOP for Zonal Task Force - 3
Tenure with other terms & conditions
• To be elected as a ZTF Chair/ Vice Chair or Zonal OR Chair, the person should at least be an
existing member of STF from any state of the Zone & with an overall association with the
Task Force mechanism (either at the level of MCCC or STF) for a minimum period of 7 years.
• State TB Officer (STO) of the State where ZTF chairman is placed will be the ex-officio
Member Secretary for of ZTF/ ZTF OR.
• Chairman/ Vice Chairman of ZTF and Zonal OR Chairman will have a tenure of three (2) years
which can be extended only once for a maximum of another tenure of 2 years. At the end of
their respective tenure, new office bearers should represent some other states of the Zone &
will have to be either elected or selected unanimously.
• Office bearers (Chairman/Vice Chairman, Zonal OR Chairman) of ZTF cannot hold dual
charges simultaneously as Office bearers (Chairman/Vice Chairman, OR Chairman) at either
the State or National level of this Task Force mechanism of NTEP except in special
circumstances.

30. SOP for Zonal Task Force - 4
Tenure with other terms & conditions
• No office bearers or members can hold the office after retirement/
resignation/ transfer or if no longer employed/associated with any Medical
Colleges of that zone. However this does not apply to anyone who after
retirement/ resignation/ transfer is employed in any Medical College within
the same zone in any capacity.
• Office bearers (Chairman/ Vice Chairman, Zonal OR Chairman) of ZTF should
be willing to spare time for the cause of Task Force activities.
• Chairman of ZTF should attend all the ZTF workshops of all the Zones. If the
chairman is unable to attend, then at least the Vice Chair should be deputed
to attend the ZTF workshops. They should also compulsorily attend the NTF
workshop.

31. SOP for Zonal Task Force - 5
Election of the ZTF chairman/ OR chairman
• ZTF chairman/ OR Chairman will be elected by STF chairpersons, STF OR
Chairs and STOs of all States in the zone. Members can decide about the 2nd
tenure to the incumbent or the new chairman of the Zonal Task Force. There
should be at least 50% members present to elect the new chairman or to grant
another tenure.
• The election of ZTF chairman will be held in the ZTF review workshop of the
respective zone.

32. SOP for Zonal Task Force - 6
• Facilitate the functioning and monitoring of State Task Force and coordinate
between the NTF and STF.
• Review & monitor the performance of all STFs in the Zone.
• Organize one ZTF workshop annually to review performance of the NTEP activities
including training of Medical College faculty/ staff in the Medical Colleges of the
zone and discuss the latest programme initiatives & policies. In case of
requirement, an emergency meeting can also be requisitioned.
• Organize Zonal Operational Research Capacity building workshops.
• Undertake operational research for NTEP on the priority areas defined by the ZTF
for the Zone. Zonal OR Chairman along with other members of Zonal OR
Committee should approve/sanction the ORs within the budget limit of of Rs 5 lakh
and more recommended
• Ensure that each State Task Force support State TB Officer in planning and
organizing Difficult To Treat TB Cases Clinics (D3C Clinics) fortnightly
Functions of Zonal Task Force

33. SOP for National Task Force…1
Formation of NTF
1.The committee has one Chairperson and two Vice Chairs along with nominated members in the Core committee in
NTF.
2.Following will be the office bearers & members of the committee:
Chairman/Vice Chair : Senior Professors of Pulmonary Medicine/ Community Medicine/ General Medicine/
Microbiology.
Member Secretary : DDG (TB)/ ADDG or any representative from CTD.
NTF Vice chars: There will be two NTF vice chairs.
NTF Advisers : There will be two NTF advisors.
Members of NTF : NTF vive chair 1 & 2, NTF Advisor (2), all the ZTF Chairmen of the respective Zones,
Directors of National Institutes, NPOs-WHO and CTD officials.
3.Special Invitees
3. Director or representative from National TB Institute: National Institute of TB & Respiratory Diseases (NITRD),
National Institute for Research in Tuberculosis (NIRT) and National Tuberculosis Institute (NTI), Bangaluru.
4. WHO Participants (National Professional Officers).

34. Medical College Task Force Mechanism
National Task Force
• Chairperson
• NTF Vice chair 1
• NTF Vice chair 2
• Member secretary
• Members
• NTF advisor
Senior Professors of Pulmonary Medicine/
Community Medicine/ General Medicine/
Microbiology.
DDG (TB)/ ADDG or any representative from CTD
All the ZTF Chairmen of the respective Zones, NTF
vice chairs (2), NTF Advisors (2), Directors of
National Institutes, WHO-NPOs & CTD officials
There will be two NTF advisors

35. SOP for National Task Force - 2
• To be elected as a NTF Chair/Vice Chair,
the person should at least be an existing member of ZTF/STF from any State/ Zone & with an overall
association with the Task Force mechanism (either at the level of MCCC or STF/ZTF) for a minimum period
of 10 years.
• DDG (TB)/ADDG or any representative from CTD will be the ex - officio Member Secretary & hence there
won’t be any fixed tenure.
• Chairman/ Vice Chairman of NTF will have a tenure of three (2) years which can be extended only once for
a maximum of another 2 years. At the end of their respective tenure, new office bearers should be either
elected or selected unanimously.
• Office bearers (Chairman/Vice Chairman) of NTF cannot hold dual charges simultaneously as Office
bearers (Chairman/Vice Chairman, OR Chairman) at either the State or Zonal level of this Task Force
mechanism of NTEP except in special circumstances.
• No office bearers or members can hold the office after retirement/resignation or if no longer
employed/associated with any Med Coll.(India)
• However this does not apply to anyone who after retirement/resignation/transfer is employed in any
Medical College of India in any capacity at any age.
Tenure with other terms & conditions

36. SOP for National Task Force - 3
• NTF chairman will be elected by NTF core committee comprising of ZTF
chairpersons, NTF advisors, Directors of Apex TB Institutes and representative from
WHO.
• Members can decide about the 2nd tenure to the incumbent or the new chairman of
the National Task Force. There should be at least 50% members present to elect the
new chairman or to grant another tenure
• The election of NTF chairman will be held in the NTF review workshop.
• Office bearers (Chairman/Vice Chairmen) of NTF should be willing to spare time for
the cause of Task Force activities.
• All the office bearers (Chairman/Vice Chairman I & II& NTF Advisors) of NTF should
attend all the ZTF workshops of all the Zones. If all of them are unable to attend, then
at least one of them should attend the ZTF workshops. They should also
compulsorily attend the NTF workshop.
Tenure with other terms & conditions

37. SOP for National Task Force - 4
1. The NTF will recommend policy suggestion and monitor the activities
of the ZTF/ STF.
2. Review & monitor the performance of different Zones.
3. Organize a NTF workshop once in a year in collaboration with CTD to
review performance of the NTEP activities and discuss the latest
programme initiatives & policies.
4. Facilitate the advocacy of policy decision and coordinate with CTD for
its implementation.
5. NTF can in special circumstance nominate a zonal chairman in case of
vacancy/ non functioning zone.
Functions of National Task Force

38. Pradhan Mantry TB Mukt Bharat
Abhiyan
A step moving towards
#TB Harega Desh
Jeetega
Invest to End TB. Save Lives

39. Thank you