Tuberculosis is not new to India. B.A.M. in India Historical records suggest that tuberculosis has been around since 1500 BC. The ‘National Tuberculosis Eradication’ program to eradicate this disease has been running for more than 50 years. However, tuberculosis, once known as a disease of the poor, has now become one that affects everyone.
Globally, tuberculosis affects four million people annually; One crore (25%) of them are Indians. The Government of India is taking various measures to protect people from the risk of TB.
It has set a target of total eradication of tuberculosis by 2025. However, medical experts are skeptical about whether this goal is feasible; The reason is that ‘Drug-resistant tuberculosis (DR-TB)’ is spreading so rapidly and aggressively in India.
Drug-resistant TB: Generally, treatment for TB is given in two phases. In the first phase, a combination of four primary drugs namely isoniazid, rifampicin, pyrazinamide and ethambutol is given for two months.
In the second phase, only Isoniazid, Rifampicin and Ethambutol are given for an additional four months. Due to years of use or misuse of such antibiotics, bacteria acquire the ability to become resistant to the drugs. This is ‘drug-resistant tuberculosis’.
There are two types of ‘drug-resistant TB’, ‘multi-drug-resistant (MDR) TB’ and ‘extensively drug-resistant (XDR) TB’. Incidences and deaths caused by these two types have been increasing rapidly across the country in recent years.
People’s Ignorance: Not only misuse of drugs; Human ignorance is also a factor in the occurrence and spread of this condition. Since cough is the only symptom of TB in the beginning, the situation gets out of hand before it is definitively diagnosed as ‘drug-resistant TB’; It spreads to many people.
According to the India TB Report 2023, about 64 percent of people with TB symptoms do not seek medical treatment; Importantly, the number of diagnosed ‘MDR-TB’ patients in India stands at 63,801.
Complex treatment: There are few drugs available to treat ‘drug-resistant TB’ and new drugs are not widely available. These drugs can also cause side effects like gastritis, headache, neurological damage, depression, hearing loss.
The cost of treatment for ‘drug-resistant TB’ is also very high. The usual treatment duration for tuberculosis is six months. But treatment for ‘drug-resistant TB’ can take up to two years. During that period, a total of 14,000 tablets would be required at 20 tablets per day. The cost of treatment for two years can range from Rs 1 lakh to Rs 25 lakh.
Testing: Special tests are needed to diagnose ‘drug-resistant TB’. These tests are often expensive; Not widely available. To meet this shortfall, the government is allocating additional funds. The number of TrueNAT/ CBNAAT test centers in the country was just 40 in 2014. Now it has increased to 5,090.
At present, there are 80 laboratories in the country to detect non-adherence to TB drugs. They have the ability to detect non-adherence to drugs such as linezolid and pyrazinamide.
Lose the opportunity? – Patents for two new drugs, Bedaquiline and Delamanid, to treat ‘drug-resistant tuberculosis’ have expired this year. They are now provided free of cost by the government.
Buying in the market can cost around Rs 2,000 per day. The government is trying to develop new short-term drugs for ‘drug-resistant TB’. ICMR’s new drug being tested in Mumbai;
Many short-term, effective medications are now available worldwide. They also have fewer side effects. The government should take measures to ensure that these drugs are brought into India and sold at low prices. Importantly, the government must ensure that no one has a monopoly on such essential medicines due to patents. Otherwise, the chance to eradicate tuberculosis will be lost.
How is it spread?
The pathogen is spread through the air when an infected person coughs, talks or sneezes. When another person breathes it in, it settles in their lungs. It hides or grows there. People with TB are likely to infect five to 15 people in close contact within a year.