Even as the Union government rejected reports of shortage of tuberculosis drugs, saying fresh stocks will arrive by July-end, World Health Organisation (WHO) on Friday asked India to consider changing the regimen from intermittent to daily doses.

One of the challenges in anti-TB drugs procurement is that only a few manufacturers produce the particular regimen used by India’s programme, which is of intermittent schedule. “WHO currently recommends governments to consider changing the regimen from intermittent to daily,” WHO Representative to India Nata Menabde said in a statement issued here.

WHO understood there was no drugs stock-out for adult patients for both drug-sensitive and drug-resistant TB at present. However, there was a dip in the buffer stock of drugs. “We understand that the government has initiated steps to ensure replenishment. Also the stock of paediatric drugs, which is critically low, is being augmented through emergency procurement,” Dr. Menadbe said.

Health and Family Welfare Minister Ghulam Nabi Azad said, “At present there is no shortage. We always keep standby arrangements and we are providing medicines from that stock. Orders have been placed and within a month supplies will be made available to the States,” he said after inaugurating a private ward at the LRS Institute of Tuberculosis and Respiratory Diseases here.

He, however, acknowledged that despite socio-economic development and advances in medical science, tuberculosis still remained a major public health concern globally.

Drug resistance

Another challenge of great concern, Mr Azad said, was the growing resistance to drugs due to irregular and incomplete treatment with irrational regimens. “This is being dealt with through appropriate expansion of diagnostic and treatment services.”

However, WHO said that for patients who had started treatment, India’s programme provided one full course of drugs for each patient. This ensured that there was no interruption of treatment due to drug shortage. Hence, the fear that there could be interruption of treatment leading to development of drug resistance was unfounded. “It is reassuring to note that the Government of India has taken urgent action,” Dr. Menabde said.

India has one of the largest TB control programmes in the world with nearly 1.5 million patients placed under treatment every year. The treatment protocol ensures that the whole course of anti-TB drugs is given free of cost to patients with intense monitoring and other patient support systems.

Since inception, the Revised National TB Control Programme has evaluated over 55 million persons for TB and initiated treatment for over 15.8 million patients. There has never been any shortage of drugs in the programme due to a robust drug forecasting, procurement and distribution system

The programme ventured on a rapid scale-up for rolling out drug-resistant TB management services and by March 2013 this service was made available to the entire population of the country.