As part of Health Care Services, the State Department of Health Services is implementing four National Programmes, viz. National Tuberculosis Control Programme, National Programme for Control of Blindness, National AIDS Control Programme and National Leprosy Eradication Programme. A review of the implementation of these programmes except National AIDS Control Programme was featured in the Report of the Comptroller and Auditor General of India for the year ended March 1987 (Civil), Government of Kerala. The report had not been discussed as of June 2001. The four programmes were reviewed in Audit during January - May 2001. The Revised National Tuberculosis Control Programme (RNTCP), a 100 per cent Centrally Sponsored Scheme, was implemented in the State covering all the 14 districts in three phases. A review of the scheme revealed low detection of TB cases due to low percentage of outpatients detailed for undergoing sputum tests, lack of infrastructure facilities for X-ray examination of sputum smear negative and extra pulmonary TB cases, shortage of microscopy centres and non-involvement of Medical College/ ESI/ Private hospitals and NGOs. The National Programme for Control of Blindness, a 100 per cent Centrally Sponsored Scheme was revised during Ninth Plan with the objective of reducing avoidable blindness due to cataract and other diseases to 50 per cent by 2002 AD. Possibility of achieving the above target was remote due to lack of infrastructure facilities for eye surgery, non-achievement of cataract surgery rate of 400 per 1 lakh population, non- functioning of eye banks and non-availability of trained eye surgeons in IOL. The National AIDS Control Programme launched by GOI in 1992 was intended to achieve maintenance of HIV@ prevalence rate below 1 per cent, reduction in blood borne transmission of HIV, creating awareness among youth, etc. The review revealed lack of infrastructure for starting new blood banks even in hospitals where equipment were supplied by National AIDS Control Organisation (NACO), delay in renewal of licence to blood banks leading to illegal functioning of blood banks, non-functioning of blood component separation units leading to lack of optimum utilisation of blood. The National Leprosy Eradication Programme (NLEP) introduced in 1982 envisaged a specialised form of treatment for leprosy known as Multi Drug Therapy (MDT). The review revealed that the NLEP activities introduced with a view to wiping out leprosy could not achieve the expected results despite the fact that the programme has been under implementation for more than 15 years mainly due to non-creation of required infrastructure facilities, lack of man power in critical cadres and lack of supervision and monitoring at all levels (Central, State, District and Unit level). The classification of district was wrongly made based on unrealistic Prevalence Rate (PR) calculated with reference to inadequate coverage of population and defective method of calculation of PR.