A group of organizations working in the health sector have urged the union health ministry to urgently solve major problems surrounding the treatment of TB and regulation of TB drugs in the country’s private market in the wake of growing number of drug-resistant tuberculosis (DR-TB) cases in India recently.

The NGOs - Médecins Sans Frontières (MSF), Peoples’ Health Movement, Stop TB Partnership and Delhi Network of Positive People (DNP+)--- said that there is an urgent need for regulatory control of sale and administration of TB drugs in the private sector in order to address the growing incidence of severe forms of DR-TB in India. “The proliferation of TB formulations in the private market coupled with the casual over-the-counter sale of antibiotics, of which some are used for DR TB treatment, is fuelling the development of drug resistance,” said Piero Gandini, MSF’s Head of Mission in India.

DR-TB is a form of TB that is resistant to standard first line TB drugs. A person can be directly infected by this form of TB or can develop it if treatment taken was not appropriate in terms of drug regimen, dosage or duration. This problem in India is compounded by an unregulated private sector that prescribes TB drugs irrationally in improper drug doses or combinations leading to drug resistance (more DR-TB). The lack of regulatory control of TB formulations in the market fuels this practice.

Blessina Kumar of the Stop TB Partnership said that the world is watching India’s growing DR-TB crisis. Now that there are new tests that can detect DR-TB in less than two hours, it’s a perfect time for the government to take immediate action to boost access to diagnosis and treatment of DR TB in the public programme so that more people are started on appropriate drug regimens and thereby reduce transmission of this disease in India.

India has the second highest DR-TB burden in the world with an estimated 99,000 new multi-drug-resistant (MDR) cases every year. Yet in 2010, only 2 per cent of the estimated cases received second-line drug treatment under the national programme. In India, the Revised National TB Control Programme (RNTCP) provides treatment to TB patients on alternate days, instead of daily treatment. This poses a higher risk for patients to miss doses, which is another key factor that leads to the creation of drug-resistant strains of TB. Further, the programme does not invest in treatment counselling that strengthens adherence to treatment, the NGOs said.