The Hindu : Kerala / Thiruvananthapuram News : Steps to ensure medicine supply to TB hospital

Online edition of India's National Newspaper
Friday, Jun 25, 2004

Kerala

Kerala - Thiruvananthapuram

Steps to ensure medicine supply to TB hospital

By Our Staff Reporter

THIRUVANANTHAPURAM, JUNE 24. The health authorities have made arrangements for purchasing increased quantities of second-line tuberculosis drugs at the Government TB hospital in Pulayanarkotta so that more patients suffering from multidrug-resistant TB (MDR TB) in the waiting list can be roped in for immediate treatment.

Inconsistencies in fund flow and procedural delay had hit the free supply of second-line tuberculosis drugs in the TB hospital. A team of district health administration officials, including the District Medical Officer and the head of the Department of Respiratory Medicine at the Medical College hospital had visited Pulayanarkotta on Wednesday following reports about the non-availability of drugs at the hospital.

Though 40 patients suffering from MDR TB, a highly infective strain of the disease, have been registered as inpatients here, the hospital could supply drugs for only 16 persons, while the rest have been included in the waiting list. About 13 more patients in the waiting list would also receive the drugs for MDR TB by the end of the week, while arrangements were being made for procuring more funds, hospital sources said.

MDR TB is a specific form of drug-resistant tuberculosis, which is caused by the incorrect, partial or inconsistent administration of first-line tuberculosis drugs like isoniazid and rifampicin. While normally, tuberculosis can be cured in six to eight months with first-line drugs, MDR TB requires extensive treatment for up to two years with highly toxic drugs that are prohibitively expensive.

"We have 40 registered MDR TB patients in the hospital and the treatment expense for two years for each patient comes to Rs. 2 lakhs. As the drugs are very expensive, we can procure these only through tenders or through the Central Purchase Committee. The treatment has to be consistent and we cannot put anyone on the drug regimen unless we are sure that we can find the funds," a doctor pointed out.

About Rs. 80 lakhs of assured funds would have to be found if treatment is to be given for all the 40 patients. An allocation of Rs. 20 lakhs that was announced for the State TB Association would be utilised for purchasing the second-line drugs now.

At present, five drugs are being administered to MDR TB patients here in various combinations. The medicines cannot be purchased and stored in bulk because each patient requires different medicines depending on their sensitivity to various drugs.

From a public health perspective, the unreliable supply of drugs or incomplete treatment of tuberculosis is much more dangerous that no treatment at all because this can result in drug resistance. Multidrug-resistant tuberculosis results when the supply of drugs is unreliable or when the patients stop taking medicines when the symptoms subside.

It was extremely important to isolate and give consistent treatment to those suffering from this strain of tuberculosis because they could pass on the same strain of drug-resistant tuberculosis to others, doctors said.

They pointed out that the hospital administration and patient care at Pulayanarkotta had been hampered by a perennial shortage of nursing and other para medical staff. According to sources, the district health administration has been hard up to find people willing to work here because of the infectious nature of the disease.

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