Recipients of federal financial assistance (FFA) from HHS must administer their programs in compliance with federal civil rights law. This means that recipients of HHS funds must ensure equal access to their programs without regard to a person’s race, color, national origin, disability, age and, in some circumstances, sex and religion. This includes ensuring your programs are accessible to persons with limited English proficiency. HHS recognizes that research projects are often limited in scope for many reasons that are nondiscriminatory, such as the principal investigator’s scientific interest, funding limitations, recruitment requirements, and other considerations. Thus, criteria in research protocols that target or exclude certain populations are warranted where nondiscriminatory justifications establish that such criteria are appropriate with respect to the health or safety of the subjects, the scientific study design, or the purpose of the research.
The other current challenge is treatment of MDR–TB. This problem is linked to the poor organization of TB treatment in the past NTP, coupled with the use of less effective regimes, which needed prolonged administration. Short–course chemotherapy, which was the standard of care worldwide, was introduced late in the NTP, and became available to all patients with TB in India only by 2006 when RNTCP achieved universal coverage. In the NTP, less than a quarter of patients (those who were smear positive) were put on short– course chemotherapy, while the rest were given long-duration drug regimens such as INH and thiacetazone, which were less effec-tive and more toxic. It is not surprising that treatment completion and cure rates were low during the NTP. These partially treated cases contributed to both the lack of decline in prevalence of TB, and increasing drug resistance seen in longitudinal studies (26, 27).