Mumbai: Apathy towards multi-drug resistant Tuberculosis (MDR-TB) patients continues as the Central government has sent only 25,000 tablets of Cycloserine for Maharashtra on Tuesday, which actually requires three lakh tablets per month. Moreover 37,200 tablets of Delamanid have also been received which is not enough to cater the needs of all the patients who are in urgent need. These two are the key-drugs for the treatment of MDR-TB.
While the country has set a target of eliminating TB by 2025, crucial three drugs for MDR-TB patients – Clofazimine, Linezolid, Cycloserine – have not been available in Maharashtra for about a month. The state health department blames the Centre for this shortage and vice versa.
A senior health official from the state health department on the condition of anonymity said that the condition of MDR-TB is getting worse due to the shortage of essential drugs.
More than 10,000 MDR-TB patients in the state
“There are more than 10,000 MDR-TB patients in the state, the highest being from Mumbai. However, patients have been facing serious problems due to drug shortages. Apart from Delamanid, the city and the state have been seeing a shortage of other TB drugs - Moxifloxacin, Cycloserine Linezolid, Clofazamine, Pyridoxine - since June,” he said.
A medical officer from the state TB department said that they have received the first stock of Cycloserine and Delamanid this week. More stocks are likely to be received but there is no official confirmation. Moreover, these stocks will be distributed to the districts based on their requirements and urgency.
Ganesh Acharya, TB survivor and activist, said that there has been no update on the availability of the other drugs and the Centre has said they will dispense TB drugs in the next 10 days.
“On October 9, the Centre dispersed 10.55 lakh Cycloserine 250mg capsules across states. Maharashtra requires 4,16,750 Cycloserine capsules but only 1.30 lakh have been given to three districts, including Mumbai (70,000), Pune (40,000) and Nagpur (30,000). But the Centre is still not taking any concrete measures to resolve the shortage,” he said.
Frequent stockouts of anti-TB drugs
Acharya further said that the last few months have been tough for drug-resistant TB patients as they struggled to get the medicines and even spend from their pockets. “Before the crisis began, the patients used to get medicines for a month. The frequent stockouts of anti-TB drugs threaten to undo the progress made through the National TB Elimination Programme,” he concluded.
Two weeks ago on September 26, a release issued by PIB India said that some media reports alleging a shortage of anti-TB drugs in India are “vague and ill-informed, without any specific information on the availability of anti-TB medicines in stock”. But in the same release, it also said that “in rare situations, states were requested to procure few drugs locally for a limited period by utilising the budget under National Health Mission (NHM) so that individual patient care is not affected.”
The Centre issued another release two days after 113 global TB organisations and more than 700 TB advocates from across the globe had dispatched a joint appeal to Prime Minister Narendra Modi seeking his urgent invention on the issue of stock-outs in India. However, the ministry issued a statement on October 1 claiming all necessary drugs were available in adequate stock – sourcing data from the Nikshay app.
The DOTS Plus Guidelines by the Centre’s Revised National Tuberculosis Control Programme also acknowledges the need for an uninterrupted supply of second-line drugs (linezolid, clofazamine, pyridoxine and delamanid). An interruption will increase the chances of developing further resistance to drugs and the risk of disease transmission to a larger community,” Acharya added.
MDR-TB patients in state 10,000
Clofazimine, Linezolid, Cycloserine – crucial drugs for MDR-TB patients, not been available in Maharashtra for about a month
On October 9, Centre dispersed 10.55 lakh Cycloserine 250mg capsules across states
Maha requires 4,16,750 Cycloserine capsules, but only 1.30 lakh have been given to three districts –
Mumbai (70,000), Pune (40,000) and Nagpur (30,000)