Dr Masae Kawamura, a US-based international expert in TB control, has called upon Indian authorities to raise the bar of standards as well as the allocation for the Revised National Tuberculosis Control Programme (RNTCP) in a big way to combat TB, especially the latent cases.

Dr Kawamura, who as San Francisco’s TB Controller was instrumental in bringing down drastically the TB cases there, also felt that India should adopt interferon gamma release assay to find out the latent TB cases which could be the bigger threat not just for India, but for the entire world due to the increasing migration.

“If India wants to fight TB, it should raise the bar as the current standards used are low. Given the budget restraints, the RNTCP is doing well. But India has to hike the budget several times. India reports two million new cases and has almost same budget like the US which reports just 10,000 cases,” she told Pharmabiz, during her recent visit to India.

Currently working as senior director of scientific and media affairs at Qiagen, she has been visiting to India to assess the RNTCP and other programmes. A TB clinician for than 23 years, she also worked in Bhutan.

Dr Kawamura, who also held talks with senior officials of RNTCP, felt that India at present was focusing on active TB cases and neglecting the latent cases which could prove dangerous, given the potential to multiply in the coming years. She said India also should focus on high-risk categories.

Referring to the infrastructure, she pointed out that there is a huge gap in the knowledge infrastructure and the country lacked a good roadmap for surveillance. “In India there are no institutes to train the clinicians whose quality and knowledge are of high importance as in the case of diagnosis. There are no centres of excellence in TB. India is lagging behind in labs,” she said, while stressing the need for involving the private sector more in the national programme.

Referring to the diagnosis aspects, she said most cases in India were treated in the 'dark' as the current test practices are bound to yield false results. She recommended that India should adopt quantiferon tests which were widely used and cost-effective in the long run. If skin tests are 59 per cent correct, quantiferon tests were 99 per cent accurate, she claimed.

Unlike the serologic tests which were banned in India because of their misuse, commercial IGRAs were rigorously studied for regulatory approval in the US, Canada, Australia, Japan and European markets where they are currently licensed for use, Dr Kawamura said, recalling her own experience as the controller.