TB drugs policy to be discussed at meet

Limited access to newer therapies in focus

In this Sunday, Feb. 2, 2014 photo, an unidentified patient suffering from tuberculosis (TB) takes his medicines which specializes in treatment of TB at Lal Bahadur Shastri Government Hospital at Ram Nagar in Varanasi, India. India has the highest incidence of TB in the world, according to the World Health Organization's Global Tuberculosis Report 2013, with as many as 2.4 million cases. India has made important strides in health in recent years, most recently by launching a successful polio vaccination campaign. But tuberculosis has remained a stubborn problem in the country, which has more than a quarter of the world's new TB cases. (AP Photo/Rajesh Kumar Singh)

Global public health agencies will discuss the Union Health Ministry’s policy on rationing new tuberculosis medicines at a forthcoming meeting in New Delhi.

The Hindu had reported on Sunday that advanced medicines to treat Drug Resistant Tuberculosis (DR-TB) were available for only about 1,000 patients.

Policy concerns

Reacting to the report, Dr. Lucica Ditiu, Executive Secretary of the Stop TB Partnership — a Geneva-based nodal agency that recommends policy interventions — said on Twitter: “We take note & serious discussions will take place in #DelhiEndTB. People with TB in India to have access to new drugs and regimens as recommended by WHO guidelines - when & whom can use. Currently, not for all - check @WHO recommendations.”

Prime Minister Narendra Modi is scheduled to deliver the keynote address at the March 12-17 ‘End TB Summit’ in the capital. The conference, hosted by the Indian government, The Stop TB Partnership and World Health Organisation (WHO) will discuss commitments from global heads of State, ahead of the UN High-Level Meeting (HLM) on TB in September. By conservative estimates, a third of the DR-TB patients need the newer therapies, Bedaquiline and Delaminid.

Case for control

Arun Jha, Economic Advisor to the Health Ministry, said on Twitter, that tighter control of new drugs is necessary to ensure patients do not become resistant to the newer therapies. “Bedaquiline & delamanid are Cardiotoxic & side effects associated need to be strictly monitored. SANS phase 3 trials, regulatory authority only permitted conditional access. As per WHO recommendation all Drug resistant patients don't need new drugs which are cardiotoxic.”

However, Professor Jennifer Furin who teaches at Harvard Medical School, said: “Patients seeking treatment for MDR-TB are not offered these drugs, with public health officials priding themselves on “saving” the drugs. Imagine if you were a person living with MDR-TB, and there is a drug that can increase your chance of cure but your physician tells you that you cannot have it because there are some un-named, un-identified populations who might 'need it in the future.' That is, essentially, what happens hundreds of times a day in India when doctors turn away DR TB patients who need the medicines,” said Prof Furin.