Shortage of key TB drugs sparks concern among activists

Mumbai: The ongoing shortage of key tuberculosis (TB) drugs for the last two months has sparked concern among activists, who have written to the union health minister, Mansukh Mandaviya, on Tuesday seeking immediate intervention.

The activists said there has been a recurrent shortage of the drugs, which threatens the Centre’s aims to eliminate TB from the country by 2025.

Jan Swasthya Andolan, an NGO working on TB treatment and patients’ rights, said since June 2023, there have been regular reports of stockouts of drugs to treat TB and MDR-TB in several DOTS and DOTS-Plus centres. “The persistent shortages have affected both first-and second-line TB drugs, including paediatric formulations,” said Ganesh Acharya, TB activist.

TB drugs that have been out of stock since June 2023 include Moxifloxacin, Cycloserine, Linezolid, Clofazamine, Pyridoxine, and Delamanid.

“We acknowledge the considerable progress made to tackle TB in the country through the National TB Elimination Programme (NTEP). However, frequent stockouts of anti-TB drugs threaten to undo these gains as inadequate and poorly administered treatment regimens facilitate drug-resistance,” said Acharya.

The DOTS Plus guidelines by the Centre’s Revised National Tuberculosis Control Programme (RNTCP) acknowledge the need for an uninterrupted supply of second-line drugs (Linezolid, Clofazamine, Pyridoxine and Delamanid).

Dr Lalit Anande, TB expert, said disruption in the supply of anti-TB drugs affects the treatment outcomes. “It not only increases the chances of developing further resistance to drugs but also increases the risk of the disease transmission to a larger community, adding additional burden on the TB programme,” said Anande.

Survivors Against TB (SATB), an association of TB survivors, experts and advocates, also wrote to Mandaviya to address the alarming shortage of vital anti-TB drugs.

“These medications are critical components of TB treatment regimens, especially MDR-TB. The reported shortage has the potential to endanger the health and well-being of patients who rely on these medications. We urge swift and immediate action from the ministry in resolving the situation,” said a SATB spokesperson.

Mumbai records more than 5,000 drug-resistant TB cases every year. In 2022, Mumbai saw 5,758 drug-resistant TB cases. In 2021, the city recorded 5,978 DR-TB cases, while in 2020 there were 4,775 cases reported. In 2019 and 2018, there were 5,997 and 5,343 cases, respectively.