By Kavita Bajeli-Datt, IANS
New Delhi : An estimated 70,000 people detected with multi-drug resistant tuberculosis (MDR-TB) require quality second-line treatment in India, World Health Organisation (WHO) experts say.
“In the Southeast Asia region there are an estimated 150,000 MDR-TB patients, of whom 70,000 are in India alone,” Nani Nair, regional advisor in the department of communicable diseases in WHO, told IANS.
“What India needs is quality second-line drugs to treat these patients who develop resistance to the first-line drugs,” she said.
MDR-TB is a totally man-made problem as people either take incorrect treatment or don’t complete it, Nair said. “TB could be easily cured if a patient takes the right drug regimen for six months regularly,” she said.
According to the just-released WHO report, “Tuberculosis in the Southeast Asia Region”, India is home to over 3.4 million tuberculosis patients – about one-fifth of the global figure – making it the most TB prevalent country.
It revealed that 325,172 people in India had died of the disease in 2005 alone. The report said that in 2006 India recorded 1.9 million new cases. Across the globe, there were 9.2 million new cases of TB during the same period.
Apart from India, WHO considers countries like Bangladesh, Bhutan, North Korea, Indonesia, the Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor as part of the Southeast Asia region. The whole region recorded 149,698 MDR-TB cases in 2006.
Of all fresh cases in the country, 1.2 percent is infected with HIV and 2.8 percent of all new cases have been diagnosed with multi-drug resistant TB, it said.
Nair said the need is to have enough manufacturers to produce quality second-line drugs. “It is important that the produce of the raw material is also increased so that capacity automatically goes up,” he said.
“India has strong pharmaceutical companies. But the need is to have labs that produce quality drugs,” she said.
Nair said WHO has a pre-qualified protocol for a pharma company wanting to manufacture such drugs.
The quality check starts from assessment of the raw material and ends at the chemist shops where the drugs are finally sold.
As per norms, experts take a look at the processing unit and after they are satisfied with the drug sample, they give them a go-ahead to produce the medicine in bulk.
But the experts continue their vigil. After the drug is prepared, they conduct further quality checks. After the drug reaches the chemist shops, another check is conducted to assess whether the drugs have degraded before their expiry date, she said.
Jai P. Narain, WHO director, communicable diseases, said the need for quality second-line drugs was identified after a study was conducted in Mumbai a few years ago where it was found that patients were getting different drugs to treat tuberculosis, resulting in a person developing MDR-TB.
He said India has taken a public-private initiative under which the government provides six months’ drugs to private practitioners who treat tuberculosis patients.
“Under this initiative, the doctor gives a commitment that he or she would ensure that the complete treatment would be provided to a person,” he added.
Under DOTS (Directly Observed Treatment, short course), the government provides free treatment to TB patients. But he said there is a need to maintain, strengthen and improve the quality of DOTS implementation across a population of almost 1.2 billion.
“We need to involve the private companies and the community members so that the tuberculosis burden of the country goes down,” he added.