Noting that the uptake of bedaquiline, an anti-tuberculosis drug, was slow in India, Soumya Swaminathan, Deputy Director General for Programmes, World Health Organisation (WHO), said it was important to ensure that the recent guidelines of WHO on the recommended drug regimen for patients with Multi-Drug-Resistant TB (MDR-TB) get converted into action quickly in the country.
Addressing the gathering at a State-level workshop on ‘TB Free Tamil Nadu - 2025’ organised by the National Health Mission - Tamil Nadu and WHO on Saturday, she said that, according to WHO statistics, India stood first in TB and MDR-TB. While reasoning that the country had a large population, she observed, “In terms of response in MDR-TB, we are a bit slow. We had a commitment from the company through U.S. Agency for International Development for 10,000 courses of bedaquiline in 2016. Today, we have used only 3,000.We know that kanamycin (another drug) causes deafness in a significant proportion of patients who have MDR-TB because they have to take it for six to nine months
Dr. Swaminathan added that the WHO now recommended that kanamycin should be replaced by bedaquiline, and kanamycin and capreomycin should no longer be used. “Bedaquiline is safe to use even in children above 12, and delamanid can be used in children above the age of three. Recently, the WHO has recommended that these drugs should be used more widely. We need to make sure that this policy gets converted into action very quickly and every MDR-TB patient is offered the choice,” she stressed.
Prevalence surveys
Citing TB prevalence surveys carried out in Tamil Nadu by the National Institute for Research in Tuberculosis, she said the latest one done in the last two to three years had shown a plateauing of the prevalence rate. “If the control programme had been doing very well, we would like to see the prevalence rate coming down significantly every time it was surveyed. The fact that the rate of decline has remained the same and the prevalence rate does not show any significant reductions means there are some things that are not doing that well,” she pointed out.
State rate
“Analysis of data from India shows that malnutrition is the biggest risk factor of TB, not HIV or diabetes,” she said. Health Minister C. Vijayabaskar said Tamil Nadu has already achieved cure rate of 84% and success rate of 90% in 2017.There are plans to launch a mobile application-based treatment monitoring system. When asked about the WHO-recommended drug regimen, Vikas Sheel, Joint Secretary, Union Ministry of Health and Family Welfare, said, it was pending with the technical committee.
Nicole Seguy, team leader for communicable diseases, WHO; Kuldeep Singh Sachdeva, Deputy Director General-TB, Central TB Division; J. Radhakrishnan, Health Secretary, Government of Tamil Nadu; Darez Ahamed, Mission Director, NHM-Tamil Nadu and K. Kolandaswamy, Director of Public Health spoke.
EOM
nica id : 208411967 (G. Krishnaswamy)
