A group of tuberculosis (TB) survivors and people working on disease treatment and patient rights highlighted that there is a shortage of essential drugs for the treatment of tuberculosis and patients with multidrug-resistant tuberculosis. across the country.
A letter in this regard was sent to Union Minister of Health Mansukh Mandaviya, Secretary of Ministry of Health and Family Welfare Rajesh Bhushan, Additional Secretary Arti Ahuja and Deputy Director General of Central Division. tuberculosis, Sudarsan Mandal.
In the letter dated August 19, Ganesh Acharya, a Mumbai-based tuberculosis survivor, pointed out that since May of this year, there have been regular reports of shortage of drugs for the treatment of tuberculosis and tuberculosis. multidrug-resistant in several short-term treatments directly observed. (DOTS) nationwide.
For effective treatment of TB patients, a trained health worker or other designated person (except a family member) provides prescribed TB drugs and ensures that patients receive their drugs regularly. This is done through DOTS centers in rural India.
“Stockouts and shortages of anti-tuberculosis drugs lead to treatment interruptions which can seriously hamper the effectiveness of treatment. Adherence to treatment is necessary for effective and complete recovery, ”the letter read.
“Poor adherence would lead to treatment failure and increase the risk of drug resistance which could be passed on to others,” warned TB survivors and activists in the letter.
Also Read: Bombay High Court Orders Central Government To Obtain Mandatory Two Patented TB Drugs
India has the highest burden of tuberculosis in the world, with around 2.69 million new cases each year, notes a 2019 report from the World Health Organization (WHO). One in four MDR-TB patients is from India.
The Indian government promises free diagnosis and treatment for all patients. India’s TB Free campaign aims to eliminate tuberculosis in the country by 2025, five years ahead of the global 2030 target. The letter warned that the shortage of essential anti-tuberculosis drugs would further strain the program by adding more drugs. case of resistant tuberculosis.
Also read: Budgam’s journey to become India’s first TB-free district
Shortage of first and second line drugs
According to the WHO, the currently recommended treatment for new cases of drug-sensitive TB is a six-month regimen of four first-line drugs: isoniazid, rifampicin, ethambutol and pyrazinamide.
Treatment for multidrug-resistant tuberculosis, defined as resistance to isoniazid and rifampicin (the two strongest anti-tuberculosis drugs) takes longer and requires more expensive and more toxic drugs.
For most patients diagnosed with MDR-TB, WHO recommends treatment for 20 months with a regimen that includes second-line anti-TB drugs such as high dose levofloxacin.
All cases of tuberculosis should be tested for susceptibility to first-line drugs, and those with MDR-TB and rifampicin-resistant enrolled on second-line rather than first-line regimens.
Also Read: Amid Fears Of Rising Tuberculosis Cases In India, Ministry Of Health Recommends Tuberculosis Screening For COVID Patients And Vice Versa
TB survivors and those working on TB treatment and patient rights have revealed that the persistent shortages thus reported have occurred in both the first and second-line TB treatment regimens.
“These stockouts were not limited to any particular state or region, but took place across the country,” the letter stressed. These data are based on information received from the community as well as from TB patients themselves in the affected areas.
Also read: Testing Times: Tuberculosis screening, diagnosis and treatment in 2020 has taken a back seat in India, which has the highest number of tuberculosis cases in the world
Impact on patients
Such stockouts would have imposed an unnecessary financial burden on patients. Running out of these essential drugs is forcing patients to switch to the expensive and often incorrect dosage of the regimen, the letter pointed out.
Lack of required treatment is believed to force patients to visit the centers several times, often skipping work, in the hope that they will receive the drug and be able to maintain adherence to the treatment regimen. “Such stockouts are therefore not only a challenge for adherence, but also force patients to choose between their health and their livelihood,” the letter says.
Also read: Explained: Double burden of COVID19 and tuberculosis
In light of this, survivors and activists urged ministers to take “swift” action to ensure a continuous and uninterrupted supply of first and second-line anti-tuberculosis drugs to all DOTS centers in India.
In addition, the network of survivors urged ministers to “urgently”
- Undertake emergency purchases and move stocks to DOTS and DOTS Plus centers experiencing stock-outs and shortages of anti-tuberculosis drugs.
- Undertake a rapid stock assessment of anti-tuberculosis drugs in DOTS and DOTS Plus centers in India and make the report on the same available to the public.
- Strengthen and streamline the drug forecasting, procurement and supply chain mechanism to avoid future stockouts.
- The Ministry of Health should establish a stock monitoring committee made up of TB program managers, supply chain experts and representatives of the TB community that meets monthly to address TB drug shortages and stockouts.
Read also: Fighting tuberculosis with nutri-gardens