The Right to Treatment

Context:

Drug-resistant tuberculosis (DR-TB) is a big challenge for India that demands urgent attention. With a quarter of the world’s DR-TB cases, India’s response can shape how other countries deal with this growing threat.

Drug resistant TB statistics for India:

• Continuously increasing burden: The WHO estimates that 119,000 new cases of multidrug/rifampicin resistant TB (MDR/RR-TB) emerge in India each year.
• Policy malfunction: The Indian TB programme has notified only a little over half the estimate about 64,000 MDR/RR-TB cases in 2022.
• Delayed Identification: However, last year in India, only about 23 per cent of those presumed with TB underwent few initial diagnostics tests.

Loopholes in India’s Policy:

• Gaps in TB diagnosis: Our inability to diagnose DR-TB rapidly is a huge gap which needs accurate tools for detection, medication and curing it.
• Ignoring BPaL regimen: India is the only global supplier of pretomanid, a key drug within the BPaL regimen. However, only 403 patients in India have so far been administered the pretomanid-containing BPaL regimen through a clinical trial.
• Century-old tools used for detection: Microscopy, which is now became old method and cannot detect drug-resistance, and detects only half of all people with these tests.

Efforts to overcome TB cases:

• WHO’s stand on BPaLM/BPaL: It has released a Standard on Universal Access to Rapid TB Diagnostics, recommending the use of molecular diagnostics as the initial test as these are highly accurate, detect resistance to drugs, are cost-effective, and reduce treatment-related delay.
• Modification in Drug usage: Shortening the duration of DR-TB treatment from 24 months to 6 months is a big improvement.
• Cost efficient method: Studies estimate an annual saving of 740 million dollars globally because of transition to BPaLM/BPaL.