The report titled ‘Out of Step’ 2017 was released on July 5 by two international organizations: Médecins Sans Frontières (MSF) and Stop TB Partnership, reviewing 29 countries of the world that account for 82 per cent of world burden and how they are combating TB.
In the report Dr Lucica Ditiu, executive director of The Stop TB Partnership reportedly said, “We have released the report two days prior to the summit to call upon the G20 leaders to wake up and do something to stop unnecessary deaths and the spread of TB, including drug-resistant TB. About 54 per cent of the 10.4 million people living with TB in the world reside in countries represented at the G20 summit.”
India’s Prime Minister Narendra Modi is attending the G20 summit in Hamburg, Germany. Apart from discussing a lot of important issues, the G20 Summit 2017 may see world leaders discuss about tuberculosis (TB) and how deadly the disease can get.
When it comes to India, the report says the weakest link in our case is diagnosis. “We all know that the prevalence rate of the disease in India is very high. Moreover, we have the highest rate of the disease,” said Dr Rajendra Nanavare, ex-medical superintendent at TB hospital and honorary chest physician. “Awareness is very important in this case. Initial prevention and early detection can help many people. Especially, as TB is curable if detected early,” he added.
One of the things that the study particularly enumerated was about the intermittent dosage. The report addresses that, India recently released its National Strategic Plan for TB Elimination, which states that the long-standing recommendation for intermittent dosing has been removed and replaced by daily treatment for all TB patients. The country aims to introduce daily TB treatment across the country in 2017. Except for India and one province of China, none of the surveyed countries use intermittent dosing during the intensive phase of DS-TB treatment.
“We need to realise that the resistance to anti-TB drugs is increasing and hence even the transmission is going higher,” said Dr. Lancelot Pinto, TB expert and consultant respirologist from PD Hinduja Hospital.
Worryingly, the report spoke at length about two major medicines and its usage in these countries. It states, India is not among the 11 countries that has approved both options, also it has not approved the shortened treatment regimen.
Bedaquiline is registered in six countries (Armenia, China, India, Philippines, Russian Federation and South Africa), and Delamanid is not registered in any of the countries surveyed for this report. These are the two important drugs for treating TB, as recommended by World Health Organizations (WHO).
Dr Pinto said, “It has been two years since these drugs have been launched, yet there is a limited availability. Something needs to be done about it to help more and more people affected with TB.”
Furthermore, it added, a recent study of anti-TB medicines from private-sector pharmacies in 19 cities reported that 9 per cent of all tested medicines were substandard; over 16 per cent in 11 African countries, over 10 per cent in India, and nearly 4 per cent in Brazil, China, Russia, Thailand and Turkey. “The private sector is a huge, unorganised sector. The issue is that a lot of people from this sector are not properly qualified to treat TB,” said Dr Nanavare.
The 29 countries surveyed for the report were home for 82% of the global TB burden. They are Armenia, Afghanistan, Bangladesh, Belarus, Brazil, Cambodia, Central African Republic (CAR), China, Democratic Republic of Congo (DRC), Ethiopia, Georgia, India, Indonesia, Kazakhstan, Kenya, Kyrgyzstan, Mozambique, Myanmar, Nigeria, Pakistan, Papua New Guinea (PNG), Philippines, The Russian Federation, South Africa, Swaziland, Tajikistan, Vietnam, Ukraine and Zimbabwe