Global fund Axshya TB project (2015-18) as SR to World Vision for Odisha and Madhya Pradesh states covering 17 districts. The objectives are to sustain and consolidate the high-yield interventions of Axshya and to implement a high-yield package of interventions for urban TB control for improving timely detection and effective management of TB cases in 17 districts of two states. The target groups reached are vulnerable and marginalised populations; Private sector health providers (qualified and unqualified, Rural Health Care Provider and traditional healers); Institutions- Corporate hospitals, labs, pharmacists and tribal and difficult-to-reach villages.

Axshya Project (2010-15), funded by Global Fund Round 9 (World Vision PR), as Sub- Recipient (SR) for Odisha and Madhya Pradesh (MP) states, LEPRA implemented this project with 16 partner NGOs covering 23 districts. The highlights include organising the state level advocacy meetings with doctors from seven medical colleges of secondary and tertiary private/govt. hospitals to promote DOTS-Plus. Facilitated MoU between Madhya Pradesh Chemist and Druggist Association & state TB cell, for their participation in early identification and referral; sensitised members of legislative assembly on TB & revised national TB control programme in Madhya Pradesh and Odisha states. Trained 7,707 government health staff (state and district level) on interpersonal communications and soft skills including the patient-friendly behaviour. 1,138 CBOs/NGOs were trained in leadership, components of TB programme which contributed formal participation and advocating with district administration, selected and trained 1,701 community volunteers in BCC tool kit, oriented 2,100 rural health care providers in delivering TB services, encouraged them in referral and DOTS provision schemes at the village level. The above engagement resulted in 79,115 TB suspect referral, supported the diagnosis of 60,014 at microscopy centred, thus detecting 4,467 TB cases.

Advocacy, Communication and Social Mobilisation (ACSM) Project (2008-10), funded by USAID for TB Control in India is a jumpstart programme implemented before GFATM R8 through World Vision. The project engaged and empowered communities for a greater role in TB control and care through improved knowledge changed attitudes and participation leading to enhanced access and utilization of TB services through the successful engagement of the private health sector and communities in ten high TB burden and underperforming districts of Madhya Pradesh and Odisha. Trained 287 (Odisha 137) NGOs/CBOs in TB activities and 96 of them engaged actively in implementing the TB activities. 3,602 community meetings, 438 schools, 351 PRI members were sensitised on TB and service provision, trained 301 AYUSH medical officers & 404 government health providers and conducted modular training to 1,214 DPs. 211 defaulter TB cases were retrieved and 19,037 TB suspects were referred of which 1,581 were detected with TB and treated with DOTS.

Arogya (Health for all) project (2009-13), co-funded by the European Union implemented in Dewas, Harda, Indore and Bhopal districts of Madhya Pradesh to strengthen and establish linkages with the work of public, private and community-based organisations so that they can respond more effectively and reach more high risk and out of reach population to HIV/AIDS and TB in the four districts. All four districts attained the key RNTCP indicators during the project period. The project increased awareness about availability of free TB treatment in public sector from 67% to 85% (baseline to end line), people from community heard about getting TB 49% to 74%, free HIV testing and counselling facilities from 36% to 83 % and availability of ART services from 9% to 83%, the willingness to undertake HIV testing from 7% to 79%, increased awareness about facts on TB-HIV from 12% to 64%. Trained and engaged 570 private practitioners on TB, HIV and TB-HIV co-infection. The project stakeholders referred to 6,930 TB suspects for diagnosis and treatment, of which 910 persons were diagnosed and treated with DOTS. Patient-provider and patient support group meetings were organised and reached 468 on-treatment TB patients resulted in 155 irregulars adhered to DOTS, 94 defaulters were retrieved for treatment, 501 persons living with HIV were supported during emergencies and they were linked with community care centres and ART centres. The project launched mobile ICTC van in the state and TB, HIV, TB-HIV data was linked with government MIS.

Culture – Drug Susceptibility Testing Scheme (2009-2017), funded by the Central TB Division implemented in Andhra Pradesh, Sikkim, and Telangana. As a state-level referral laboratory – IRL for MDR TB diagnosis culture and drug susceptibility testing and MTBDR Line Probe Assay. With district TB officials’ support, the sputum samples were collected from MDR suspects and MDR treated cases (follow-up) on schedule at the field level, as per RNTCP – technical operational guidelines of DOTS-Plus. The samples are packed in a triple pack system maintaining the cold chain and labelled as bio-hazard, transported to the BPHRC laboratory within 72 hours of specimen collection. During 2009-16, 2,285 MDR suspects from TB and TB-HIV co-infection were tested, of which 511 diagnosed as MDR-TB cases. 24,946 M-X-DR-TB patients were monitored for treatment response through frequent sputum cultures. During 2012-16, 592 XDR-Suspects from M-DR-TB culture positive isolates were screened & transported for base-line drug susceptibility tested at NIRT-Chennai, of which 79 diagnosed as XDR cases.

Buniyad Project (2008-12), funded by Big Lottery Fund, LEPRA implemented this project in 3 endemic districts namely Jhabua, Burhanpur and Khargone with district offices for leprosy, TB, HIV, and TB-HIV. The project improved the health and livelihood outcomes of SC and ST to reduce the burden of poverty upon them by mitigating the health and socio-economic impact of TB, TB/HIV co-infection and leprosy on tribal communities. It strengthened government health services for delivering effective preventative and curative action to reduce the risk of contracting TB and HIV/AIDS, evidenced by a 90% cure rate for TB, optimum HIV testing levels (4-5 tests to 15 tests per day per testing centre) and a 15% rate of TB/HIV co-infection detections in the project area. 80% of scheduled caste and scheduled tribe communities put their knowledge on health prevention techniques into action and reduction in discrimination against people affected by leprosy, TB and HIV and increased uptake of government welfare schemes.

The key activities are strengthening community-level structures and government health services for leprosy, TB and HIV; mobile ICTC, community mobilisation, and awareness; developing local specific IEC materials, support government in implementing RNTCP and ICTCs. The accomplishments of this project are 10,054 suspects were accompanied by the stakeholders for diagnosis of TB, HIV, and leprosy. 18% of TB suspects, 3% of HIV and 54% of leprosy cases were confirmed and initiated for MDT treatment; developed 220 village-level volunteers and trained in leprosy, TB, HIV, TB-HIV co-infection; established 150 sputum collection centres in remote tribal areas and 2,174 sputum samples collected and 209 treated with DOTS; reached 21,100 pregnant women who have undergone HIV testing at MICTC out of which 26 were found to be HIV reactive and Nevirapine administered on 24; 9,672 people (vulnerable) received treatment through the OPD of which, 1,444 were treated for STIs at STI clinic; strengthened the function of 12 poor-performing microscopy centres; 2,267 HIV-TB co-infection cases were referred and treated; HIV testing facilities increased their capacity from conducting less than 4 tests to 13 per day at 3 ICTCs and 488 beneficiaries were linked with various government welfare schemes – “safety net” benefits.

Sahayog project (2008-12), the European Union and Lepra UK supported “Reaching the unreached” – the project aimed at strengthening the health system to reduce tribal vulnerability to TB and HIV/AIDS. The project contributed to reducing the burden of TB and TB/HIV co-infection in tribal communities in Rayagada, Koraput & Malkangiri districts of Odisha and supported the government in the implementation of tribal TB action plan. The project improved case detection, sputum conversion and cure rates of TB and TB-HIV co-infected in 3 districts. Ensured functioning of 180 sustainable sputum collection centers by engaging 646 traditional healers/private practitioners and developed 299 community volunteer cadre. Improved the TB performance in the tribal districts by detecting 1,864 TB cases, 3987 women have accessed HIV services. Improved the skills and capacities of 6,050 service providers and 1,482 ‘gaon kalian Samiti’ members, 798 PRIs, CBO/NGO officials, in addressing TB, HIV and TB-HIV co-infection. Established 100-grain banks in 3 districts and benefited more than 3,000 households and 200 TB patients were benefited through grain banks for food security.