Tuberculosis (TB) is a major public health problem in Nepal. About 45 percent of the total population is infected with TB, of which 60 percent are adult. Every year, 40,000 people develop active TB, of whom, 20,000 have infectious pulmonary disease. There 20,000 are able to spread the disease to others. Treatment by Directly Observed Treatment Short course (DOTS) has reduced the number of deaths; however 5,000-7,000 people still die per year from TB. Expansion of this cost effective and highly successful treatment strategy has proven its efficacy in reducing the mortality and morbidity in Nepal. By achieving the global targets of diagnosing 70 percent of new infectious cases and curing 85 percent of these patients will prevent 30,000 deaths over the next, five years. High cure rates and Sputum conversion rate will reduce the transmission of TB and lead to a decline in the incidence of this disease, which will ultimately help to achieve the goal and objectives of TB control. DOTS have been successfully implemented throughout the country since April 2001. The NTP has coordinated with the public sectors, private sectors, local government bodies, I/NGOs, social workers, educational sectors and other sectors of society in order to expand DOTS and sustain the present significant results achieved by NTP.
To reduce the mortality, morbidity and transmission of tuberculosis until it is no longer a public health problem in Nepal.
- Achieve universal access to high quality diagnosis and patient centred treatment.
- Reduce the human suffering and socioeconomic burden associated with TB.
- Protect poor and vulnerable populations from TB, TB/ HIV and multidrug resistant TB.
- Support development of new tools and enable their timely and effective use.
Targets linked to the MDGs and endorsed by the Stop TB Partnership:
- By 2005: detect at least 70 percent of new sputum smear positive TB cases and cure at least 85 percent of these cases.
- By 2015: reduce prevalence of and death due to TB by 50.
- By 2050: eliminate TB as a public health problem (<1 case per million population).
For ages, leprosy has been a disease causing public health problem and has been a priority of the government of Nepal. Thousands of people have been affected by this disease and many of them had to live with physical deformities and disabilities.
According to a survey conducted in 1966, an estimated 100,000 leprosy cases were present in Nepal. Dapsone monotherapy treatment was introduced as a Pilot Project in the Leprosy Control Program. Nepal Leprosy Control Program was started in the country in 1996. Multi Drug Therapy (MDT) was introduced in 1982 in few selected areas and hospitals of the country. By this time, the number of registered leprosy cases had reached 21,537 with a Prevalence Rate (PR) of 21 per 10,000 populations. Sixty-two districts of the country had PR of over 5, while only three districts had PR less than 1 per 10,000 inhabitants.
Evolution of Leprosy Control Program
- 1960 Leprosy survey in collaboration with WHO
- 1966 Pilot Project launched with Dapsone therapy
- 1982 Introduced of Multi Drug Therapy
- 1987 Integration of vertical program into general basic health services
- 1991 National leprosy elimination goal was set
- 1995 Focal persons (TLAs) appointed for districts and regions
Reduce further the burden of leprosy and to break channel of transmission of leprosy form person to persons by providing quality service to all affected community.
- To eliminate leprosy (Prevalence Rate below 1 per 10,000 population) and further reduce disease burden at district level;
- To reduce disability due to leprosy;
- To reduce stigma in the community against leprosy; and
- Provide high quality service for all persons affected by leprosy.