'Logistics' is the process of planning and implementing the efficient transportation and storage of supplies (drugs, consumables and other related items) from the point of origin to the point of consumption through a systematic mechanism.
Under the National TB Elimination Programme (NTEP), the anti-TB drugs are procured at the centre level by the Central TB Division (CTD), Ministry of Health and Family Welfare (MoHFW), and supplied to the central warehouses.
From the central level warehouses, the drugs are supplied to different State Drug Stores (SDS) and further distributed to District Drug Stores (DDS) and sub-district level (TB Unit (TU) Store and Peripheral Health Institute (PHI)).
This movement of drug flow is monitored in real-time through Ni-kshay Aushadhi.
To ensure successful implementation, sustainability and quality services under the National TB Elimination Programme (NTEP), some guiding principles in Supply Chain Management (SCM) and drug logistics are to be ensured. These are showcased in the figure below.
Figure: Principles of SCM under NTEP
Important Points
Private health providers are an inevitable part of the TB treatment and support in the country. These private providers include:
To improve complete reporting and ensure support care for patients in the private sector, the facilities will receive an incentive of:
Special provisions have been made in the tribal, hilly and difficult to reach areas of the country under the National TB Elimination Programme (NTEP) to expand diagnosis and treatment centres, improve access for TB patients and coverage of TB services.
To provide access to diagnosis and treatment centres for people in the tribal areas, NTEP has initiated transport support for TB patients in notified tribal areas from the year 2019.
Transport support is available for patients receiving treatment from both the private and public sectors.
Nikshay Poshan Yojana (NPY) is one of the four initiative-based support schemes which provides financial support to TB patients for their nutrition. A financial incentive of Rs. 500 per month will be provided to patients on anti-TB treatment till the completion of treatment.
There may be other Central or State government schemes and programmes that beneficiaries related to the TB program are eligible for, over and above the 4 schemes provided by the central government through NTEP. Some examples are:
Figure: Components of Ayushman Bharat Yojana
In the National Sample Survey Office (NSSO) 68th round 2011-2012, India was reported to have the highest out-of-pocket expense on healthcare, of which over 67% was spent on drugs. Recognising the importance of essential drugs being available and accessible to the general public, the Ministry of Health & Family Welfare, Govt. of India, implemented the Free Drugs Service Initiative (FDSI) under the National Health Mission (NHM) in 2015.
Objectives