also accredited as Culture & Drug Susceptibility Testing laboratories for tuberculosis (i.e. Microcare Laboratory & tuberculosis Research Centre, Surat) Stigma Disempowerment and stigma are often experienced by TB patients as they are disproportionately impoverished or socially marginalized. The DOTS treatment regimen of the RNTCP is thought to deepen this sentiment, as its close monitoring of patients can lead to stigma. To counteract disempowerment, some countries have engaged patients in the process of implementing the DOTS and in creating other treatment regimens that give more attention to their nonclinical needs. This knowledge can complement the clinical care provided by the DOTS. Pro-poor strategies, including wage compensation for time lost to treatment, working with civil society organizations to link low income patients to social services, nutritional support, and offering local NGOs and committees a platform for engagement with the work done by private providers may reduce the burden of TB and lead to greater patient autonomy. Economics Some legal advocates have argued that public interest litigation in India must be part of the TB response strategy to ensure that available resources actually fund the necessary health response. India has a large burden of the world's TB, with an estimated economic cost of US$100 million lost annually due to this disease. Special populations How Scheduled Tribes and other Adivasi are coping with TB highlights a lack of research and understanding of the health of this demographic. There is a belief that this community is more vulnerable and has less access to treatment, but details are lacking on how TB affects tribal communities. References Further consideration External links Central Tuberculosis Division of the Government of India