The Government of India is orchestrating a resurgence of the antibiotic Penicillin in a coordinated effort to counter drug resistance and control the widespread occurrence of rheumatic heart disease.
The Backstory of Penicillin
Penicillin, discovered in 1928 by Alexander Fleming, was the inaugural antibiotic. Soldiers wounded during World War II significantly benefited from this treatment. It continues to be the first-line antibiotic drug in numerous western nations. However, in India, Penicillin practically disappeared from the markets due to untenable price control measures implemented by the government. These controls were so tight that manufacturing the drug became uneconomical, prompting manufacturers to cease its production. Consequently, only the pricier derivatives of Penicillin are prescribed today.
Understanding the Impetus for Revival
India carries a large share of the global rheumatic fever and rheumatic heart disease burden, which often remains undiagnosed, contributing to maternal deaths during childbirth. Rheumatic fever is a persistent issue plaguing around 25-45% of acquired heart disease patients in the nation. As per population-based studies, approximately 2 in every 1000 people in India suffer from rheumatic heart disease. This incidence rate escalates to 6 in 1000 among children aged 5-16 years, as per surveys conducted by the Indian Council of Medical Research (ICMR). The Health ministry asserts that rheumatic fever and heart disease can be effectively treated with Penicillin, the most affordable treatment option available.
Maternal Mortality and Rheumatic Fever
In the context of maternal health, the World Health Organization defines maternal death as the demise of a woman during pregnancy or within 42 days post-pregnancy termination, caused by or exacerbated by pregnancy or its management. India’s maternal mortality ratio (MMR) stood at 130 per 100,000 in 2016.
Rheumatic fever is an inflammatory disease that can occur as a consequence of inadequately treated strep throat or scarlet fever, and may inflict permanent damage to the heart, such as damaged heart valves and heart failure. Although not all sore throats evolve into rheumatic fever, if untreated, some may advance into a disease that necessitates heart valve replacement.
| Fact | Value |
|---|---|
| Prevalence of Rheumatic Fever | Most common in children aged 5-15 years |
| Cause of Rheumatic Fever | Follows an infection of the throat with a bacterium called Group A streptococcus. |
Government’s Plan of Action
Recognizing the key role Penicillin plays in rheumatic fever treatment, the government is devising a strategy to centrally procure Penicillin for three years and administer it to all children aged 5-15 years presenting with a sore throat. The proposed dispensation method involves primary health centres or delivery by Accredited Social Health Activists (ASHA) workers.
Apart from revitalizing Penicillin availability, the government is also contemplating coordinating with the National Pharmaceutical Pricing Authority (NPPA) to remove it from the price control list. To stimulate production again, the government will procure the medicine centrally for three years, thus providing manufacturers with the necessary incentive to resume manufacturing processes.