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2nd step: Revise policy & targets keeping the Indian patient in view. His poverty, illiteracy and his beliefs should be given first importance while formulating a relevant policy and targets.
3rd step: Make direct observation foolproof. Use preferably family member as dots observer by some mechanism (incentive) as no one else is more dependable to observe the treatment. Health workers are overloaded. Village teachers etc are less reliable even though they were paid. People usually don't go near a patient unless strongly motivated. This we can do only with kith and kin.
4th step: Community sensitization: Even Prime minister of India can not be successful, if the people are not actively involved in Tb control. Make the health professionals know and practice Dots regimens, if necessary by legislation to prevent MDRTB.
5th step: Strong Information education and communication activities are imperative to increase awareness and relieve the doubts and superstitions. Mass media should take up the cause on war footing basis. Only on World Tb Day, two days ago, I have seen anti tb slogan in television for the first time. Establish village tb clubs including patients.
6th step: Utilize all human resource available particularly the youth . Give the college youth the printed pamphlets and ask them to visit villages for motivation during vacation periods.