National Project Implementation Plan - NVBDCP

agent of the DMO) will annually sample the LMIS data and verify the chain of
transactions from the time of delivery in the district down to service delivery
points in PHCs to authenticate the information. This same agent will assess the
quality of ACT/RDT, ‘rk39’ or first line medicines for kala-azar and vector
control supplies storage facilities. The LMIS will not track the distribution of
LLINs and ACTs to patients as that is the role of the HMIS. The MOHFW is in
the process of establishing a comprehensive LMIS for the health sector with
support from DFID in three states. Two of these states where such piloting is
taking place are also malaria endemic states proposed to be included under the
project (Orissa and Madhya Pradesh) and efforts would be made to ensure
integration of the project LMIS with this initiative. RNTCP has hired the services
of Consultant agency for supply chain management for keeping track of
inventory down from block level to state level. The same agency shall be hired
by NVBDCP for similar work.
(c) System to monitor the quality of rapid diagnostic tests and medicines to
ensure their quality upon delivery and at point of use
NVBDCP has prepared a protocol for monitoring the quality RDTs in accordance
with WHO recommendations and technical documents. This will now translate
to an action plan, which includes the training of a limited number of laboratory
technicians in each state, who will sample and control RDTs. Similarly, a
protocol will be established for quality assurance of antimalarial medicines
(especially ACTs), which will be sampled according to established and approved
protocols in the context of the work described under (d). NVBDCP will seek
Consultant from WHO for this purpose. Quality assurance of ‘RDK and first line
drugs used in the treatment of kala-azar will be undertaken with the help of
RMRI, Patna. Help will also be taken from the Regional Directors, ROHFW for
implementation.
(d) Monitoring of parasite resistance to antimalarial medicines, in particular
the first-line ACT (artesunate plus sulfadoxine-pyrimethamine), Miltefosine and
vector resistance to insecticides
With the adoption of an ACT including the long-acting sulfadoxinepyrimethamine
(SP) as a component, close resistance monitoring including
molecular markers becomes essential. This work will be led by NIMR, which has
established a protocol in collaboration with NVBDCP. ACT therapeutic efficacy
and molecular markers for SP resistance will be collected from 30 sites, where
patients will be sampled and examined every second year in each site. In
addition, susceptibility of P.vivax to chloroquine will be monitored in 3-4 of
these sites. Monitoring of resistance to miltefosine will be undertaken in three
(3) sites by rotation and RMRI will be involved in oversight of this activity.
Monitoring of insecticide resistance across the country has been weak for many
years despite the availability of trained entomologists in research centres. A
protocol has been established by NIMR in collaboration with NVBDCP to assess
over a 5-year period, the susceptibility of anopheline vectors to the main
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