Amid key victories in fight against TB, states face one battle: Shortage of drugs

Contact Counsellor

CategoryHealth

Last Updated07/12/2024

Last month, the World Health Organisation highlighted two significant milestones in India’s fight against TB: an 18% dip in cases over the past 10 years, more than double the global rate; and a 24% reduction in deaths in the same period, higher than the global average of 23%.

India has achieved significant progress in its battle against tuberculosis (TB), but challenges such as drug shortages threaten its ambitious goal of eliminating the disease by 2025.

Reduction in Cases and Deaths:
- The World Health Organization (WHO) reported an 18% decline in TB cases and a 24% drop in deaths over the past decade, both surpassing global averages.
Treatment Coverage:
- In 2023, 85% of India’s estimated 27 lakh TB patients were receiving treatment, a notable achievement in addressing a disease with a high mortality rate in untreated cases.

India’s TB treatment involves two stages:
- Intensive Phase (IP): Two to three months of combination antibiotics.
- Continuation Phase (CP): Four to seven months of additional antibiotics.
However, data highlights a decline in the availability of these Fixed-Dose Combination (FDC) drugs:
- 2023: A 56.5% drop in IP drug supply and a 23% dip for CP drugs compared to 2022.
- 2024 (Jan–June): IP drug supply fell by 23.04%, and CP drugs saw a 28.8% decline compared to the same period in 2023.
Reasons Behind the Shortages
- Canceled tenders by the nodal procurement agency due to “administrative reasons.”
- Blacklisting of three suppliers for violations such as forged documents and faulty pricing.
- States were urged to procure drugs locally to address the shortfall, with provisions for reimbursing patient expenses if free drugs were unavailable.

Elimination Target:
- Announced at the 2018 “End TB Summit,” the Government aims to eliminate TB by 2025.
Drug-Resistant TB:
- Delays in drug supply risk creating drug-resistant TB cases, arising from incomplete treatments. These cases are costlier to treat, with monthly costs of Rs 20,000–30,000 for resistant strains compared to Rs 10,000 for regular six-month treatment in private healthcare.

High-Burden States:
- Uttar Pradesh (6.3 lakh cases), Maharashtra (2.27 lakh), Bihar (1.86 lakh), Madhya Pradesh (1.84 lakh), and Rajasthan (1.65 lakh) report the highest numbers.
Global Context:
- India accounts for 26% of global TB cases and 29% of TB deaths.

India’s achievements in reducing TB cases and deaths reflect strong public health efforts. However, addressing systemic issues such as drug supply chain disruptions and ensuring buffer stocks are crucial to sustaining progress and preventing drug resistance. Strategic interventions and consistent policy implementation will be pivotal in meeting the 2025 target.