The “Step Up for TB 2020” report by the Stop TB Partnership and Médecins Sans Frontières/Doctors Without Borders (MSF) has brought to light India’s conservative stance towards new medicines for drug-resistant TB. This approach endangers the lives of many patients, including children. The current pandemic has exacerbated the plight of TB patients, affecting disease diagnosis, surveillance, and treatment.
A Brief on Médecins Sans Frontières (MSF)
Established in 1971, MSF, also known as Doctors Without Borders, is a French NGO internationally recognized for its humanitarian medical projects in conflict zones and countries affected by endemic diseases. MSF was awarded the Nobel Peace Prize in 1999.
Understanding Tuberculosis (TB)
Tuberculosis, caused by Mycobacterium tuberculosis bacteria, primarily affects the lungs. It spreads through the air when people with lung TB cough, sneeze or spit. Symptoms include coughing with sputum and blood, chest pain, weakness, weight loss, fever, and night sweats. TB is a curable disease treated with a standard 6-month course of four antimicrobial drugs.
Highlight on Drug-Resistant TB
Multidrug-resistant tuberculosis (MDR-TB) is a form of TB unresponsive to first-line anti-TB drugs. Extensively drug-resistant TB (XDR-TB) is a more severe form unresponsive to the most effective second-line anti-TB drugs. Despite being curable, TB remains the world’s deadliest infectious disease, claiming over 1.4 million lives in 2019 alone.
Key Insights from the Report
The report shows data on 37 high-burden countries, including India, assessing their national policies against international best practices. It focuses on diagnosis, treatment, prevention, and medicines procurement policies. The report found policy adoption and implementation barriers across surveyed countries and stressed prioritizing oral treatment regimens for DR-TB patients.
India Specific Findings
India faced criticism for not scaling up new DR-TB drugs, with less than 10% of India’s MDR-TB patients receiving Bedaquiline until March 2020. This situation is worrying as India harbors a quarter of the world’s DR-TB patients and has the highest TB burden globally.
India’s Fight against TB
India’s National Tuberculosis Elimination Programme was launched to eliminate TB by 2025, five years ahead of the WHO’s global target. The country also introduced the Nikshay Ecosystem–a national TB information system, Nikshay Poshan Yojana–a scheme for TB patients’ nutrition support, and the TB Harega Desh Jeetega Campaign showcasing commitment towards TB elimination.
Global Interventions
The WHO, in collaboration with the Global Fund and Stop TB Partnership, launched the “Find. Treat. All. #EndTB” initiative. The WHO End TB Strategy targets to reduce TB deaths by 90% and cut new cases by 80% between 2015 and 2030.
The Way Forward
Despite significant achievements by various programmes, more efforts are necessary to improve early and accurate diagnosis followed by prompt appropriate treatment. India must collaborate with global initiatives to eliminate TB and shift the measures for TB control.
