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Will the New Shorter Treatment For TB Be a Game Changer In India?

Doctors in India are skeptical about the new, shorter treatment of TB

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Imagine having an airborne disease which can kill you if it is not treated with over 14,000 pills and 240 injections.

Imagine having to continue this treatment with side-effects like deafness, nausea, loss of appetite, possible depression for more than two years, that too in isolation because no one wants to come close to you for the fear of contracting the infection.

Unimaginable?

That’s the state of over three million tuberculosis (TB) patients in India.

But now an easier and a cheaper drug regime which cuts down the treatment from two years to nine months has been approved by the World Health Organisation (W.H.O.) for people who suffer from drug resistant tuberculosis.

Every day in India, 1000 people die of tuberculosis. The World Health Organisation says, that’s primarily because one in five TB patients do not complete their long, exhausting treatment, while for one in ten patients the treatment fails.
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Shorter, Cheaper TB Treatment, Faster Diagnostic Tests

Doctors in India are skeptical about the new, shorter treatment of TB
The average cost to a family who has one person suffering from TB can amount to as much as 39% of annual household expenditure – a catastrophe for any family already impoverished (Source: Report by the Joint Monitoring Mission of the RNTCP) (Photo: The Quint)

The new shorter treatment plan uses different doses of existing drugs which were previously used for leprosy.

The trial of this new treatment was done by the International Union against TB and Lung Disease and Medecins Sans Frontieres in Bangladesh and nine African countries, the positive results of which influenced the WHO’s decision.

The complete guidelines by the World Health Organisation which propose for shorter, cheaper treatment for treating drug resistance TB will be released by next month. Doctors associated with it have urged countries to implement these guidelines soon after.

Given that around 10% of TB cases have complete resistance to the two most effective drugs - a shorter treatment plan will cost a patient less than Rs 70,000 per month, in comparison to the nearly two lakhs per month being incurred by patients in the private sector. 

The WHO is also recommending a new, faster genetic test for multidrug-resistant TB, which gives results within two days, compared with the current three months.

Faster results will mean that almost zero time is lost in trial and error of treatment options, patients can quickly be put on second-line drugs in case of resistance.

Doctors Skeptical About the New Treatment For India

Doctors in India are skeptical about the new, shorter treatment of TB
An ancient disease, TB is still one of the world’s leading killers, claiming more lives every year than HIV/AIDS, though the two diseases are inextricably linked (Photo: AP)

Currently, TB experts in Mumbai treat a third of their patients who are incurable with standard medicines. TB is a highly infectious disease, so the discovery of an almost untreatable form of TB ( extensively drug resistant TB or XDR TB) in Mumbai, set off alarm bells around the world.

The fear in the medical community is that if almost all known tuberculosis drugs did not work on some Indians carrying the extremely drug resistant strain of TB, how will a shorter regimen of old drugs work?

I have my doubts regarding this new treatment for our population. India has the highest number of drug resistance cases in the world, independent studies have proved that neither of these old drugs which the WHO is talking about have previously worked in India.
Dr Sapatnekar, Infectious Diseases Specialist

The economic repercussions of TB are catastrophic, often the patient is the breadwinner of the family.

TB already causes an estimated 100 million workdays’ loss for India (Source: RNTCP). So if the shorter treatment works even for some patients in the country, the benefits will be manifold.

Multidrug-resistant TB remains a huge public health challenge.

It’s a no-brainer that newer drugs to fight this deadly disease are the need of the hour. Besides Bedaquiline, the only TB drug developed after six decades of research (in 2014), there is no new treatment option in the pipeline. What’s worse, there is no major push for pharmaceutical giants to develop a drug for a disease which mostly affects third world countries.

Related Read: Will the New TB Drug For Kids Wipe Out the Deadly Disease?

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