India has a highly variant TB epidemiology and extreme difference in health system strength. One national strategy will not translate to effective on ground activities. STDCs need to technically support the state in identifying bold programmatic changes designed to accelerate progress toward "TB Elimination". STDCs based on its understanding of the State, need and context (TB epidemiology, strength of health system, resources available), needs to prepare and evolve action plan toward TB Elimination. The action plan while being in alignment with the interventions of the NTEP strategy, needs to consider the TB burden of the state, special population groups related to TB (vulnerable groups, migrants etc.). Based on this context the strategic interventions may add on to existing NTEP and may be directed towards 

1. Early and complete TB detection
2. Correct and complete treatment 
3. Prevent new infection and break down to active TB
4. Health system strengthening for TB care

The STDCs need to technically support STCs in preparing the annual action plan as per the state strategy for PIP preparation. This would include:

• Gap Analysis: The STDCs need to undertake district-wise gap assessment through analysis of the existing data, observations from the supervisory visits and periodic evaluations, a district-wise gap analysis need to be prepared. Gap analysis should highlight what are the major program gaps in terns of infrastructure, equipment, HR, activities and funds in each district. 
• Identification of priority activities: Based on gap analysis, STDCs need to help the districts and state to identify the activities to be included on priority basis in the PIP of the respective district and state level. 
• Capacity building and mentoring of district: STDCs should support DTO to prepare the PIPs of their respective districts including the micro-plan for each activity with number of beneficiaries and expected outcomes with proper justification. This may be done in a workshop mode before the preparation of the state PIP. 

Medical Officer (SM&E) will be the nodal person who is responsible for the activity under the overall guidance of the Director STDC and STO.

The STC has been provided ACSM Officer from the NTEP for carrying out and coordinating the ACSM activity in the State. The overall responsibility of ACSM activity would therefore lie with the STC. The STDCs would be required to provide technical inputs to make the ACSM activities more effective and also take certain advocacy activities themselves. The Key role of STDC is described as under: STDCs need to provide technical support to STC for:

• Advocacy with political and administrative officials at state and district level to obtain approvals on plans and secure necessary resources for the interventions in state TB elimination strategy. These may be from sources such NHM, State Health System, Government representatives, Panchayati Raj Institutions, private and corporate entities, and the civil society and community at large.
• Advocacy with scientific/ professional/ academic organizations/ institutions, Political leaders, Opinion leaders, non-governmental organizations (NGOs), TB Champions, AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy), Corporates and other government departments for implementation of the state TB Elimination strategy and for following Standards of TB Care in India
• Designing and Development of Advocacy and Information, Education and Communication (IEC) material in local language including contents for social media.
• Supporting the state and districts to develop annual ACSM plan.
• Dissemination of programme performance through publication of Bulletin / Newsletter every quarter.
• Design and implement “TB-Free Village” Certification as an advocacy initiative

It is pertinent to have a clear understanding of the Epidemiology of TB in the state in terms of its burden (incidence and mortality rates) and its trends, identification of vulnerable populations, hot-spots of transmission of TB particularly of drug resistant TB, etc. The STDCs are expected to play a lead role in surveillance, by: -  

1. Ensuring correctness, completeness and timeliness of Ni-kshay data and other program data at all levels through day to day monitoring and necessary hand-holding.
2. Periodic analysis of programme data.
3. Collection and analysis of: a) Drug sales data and b) Schedule H1 data
4. Mathematical modelling in collaboration with domain experts to forecast resource requirements, predict impact of specific interventions etc.
5. Collect additional information, to understand/ estimate the time place and person changes in the burden of TB by undertaking surveys.
6. Dissemination of the analytics at all levels within the state and outside the state.                 

​​​​​​​​​​​​​​The STDCs should co-ordinate and collaborate with Community Medicine Department of Medical Colleges, Public Health Institutes and Mathematics department of science Colleges including Indian Institute of Technology (IIT) and Indian Institute of Management (IIM). Epidemiologist will be the nodal person responsible for the activity.

STDCs should support the state in strategically customizing and scaling up the new interventions and programme guidelines issued by CTD, from time to time, or as per state requirements for TB Elimination.

Specific roles of the STDC in this regard are as follows: -​

• Mapping of all stakeholders for engagement 
• Develop necessary training and communication material in local vernacular language.
• Develop and implement a training and capacity building plan​.
• Prepare and implement the supervision and monitoring plan.​
• Document the initial lessons and disseminate it for wider use.
• Support budgeting for implementation of the newer activities in the annual PIP.

The NSP encourages and promotes Operational Research to generate evidence on effectiveness of interventions and strategies aimed towards TB elimination. The STDC being the technical support arm of the STC should actively take a role in planning and conducting Implementation Research(IR)/ operational Research(OR). 

The STDCs should independently plan and execute need-based Ooperational/ Implementation Research (OR). This would include:

1. Identify research priority for the state to better achieve the program objectives in alignment with the Operational Research guidelines of NTEP.
2. Disseminate research priority areas with the potential researchers, institutes, and agencies for the conduct of Operational Research. 
3. Organize capacity building sessions for interested program staff to design research studies and proposals in the form of an Operational Research workshops (Protocol Development, Report writing).
4. Call for Proposals, review & approval of proposal in coordination with State Operational Research Committee
5. Setup and host a formal Institutional Ethics Committee to review and approve any research proposals. They may also leverage any existing IEC at a co-located institution.
6. Applying for and securing funds for executing research studies from external sources.
7. Support state OR committee to execute approved studies
8. Review progress of approved studies every quarter
9. In coordination with Medical college task force, STDCs should also plan to conduct Operational Research dissemination workshop annually. 
10. Advocate for policy/ operational changes in the state and the country, based on Operational Research findings.
11. Maintain a data base of all TB research (past/ ongoing/ published) from the state
12. Evaluate and Document best practices in the state, and disseminate them by publishing related reports in periodicals/ journals for necessary programmatic uptake

The Epidemiologist of STDC will be the Nodal Officer for Operational Research related activities.

STDC should ensure that required budget for Operational Research related activities are proposed through the PIP mechanisms. It is essential for the STDC to have a concrete plan in terms of number of research projects proposed in the PIP.

Under NTEP it is ongoing, regular & systematic surveillance conducted annually by CTD across the India. STDCs will support the conduct of annual SNC activities. In addition to that STDCs need to support SNC in the following ways​

• Preparation and selection of districts for SNC claims including secondary data compilation and analysis​
• Engaging with the available Public Health experts from Medical Colleges and other institutions. ​
• Supervision ​and monitoring the quality of the SNC process
• Training of volunteers​.