Developments in TB treatment- Improved drug regimens for TB to cut treatment time

Source: The post Developments in TB treatment has been created on the article “Improved drug regimens for TB to cut treatment time” published in “The Hindu” on 8th December 2023.

UPSC Syllabus Topic: GS paper 2- Governance- Issues relating to development and management of Social Sector/Services relating to Health.

News: The article talks about The Union World Conference on Lung Health 2023, where new, shorter drug regimens for drug-resistant tuberculosis were introduced. It highlights challenges in current TB treatments, advancements in research, and the importance of improved diagnostics and a comprehensive approach to combat TB.

What is the current status of TB in India?

According to WHO Global TB report 2023:

1) In 2022, India had the most tuberculosis (TB) cases globally, with 2.8 million, making up 27% of the world’s total.

2) The death rate from TB in India was 12%.

3) India also saw 1.1 lakh cases of multidrug-resistant TB (MDR-TB) in 2022.

Note: Multidrug-resistant TB (MDR-TB) is TB that does not respond to at least isoniazid and rifampicin, the 2 most powerful anti-TB drugs.

What challenges exist in current TB treatments?

Diagnostic Gaps: According to the WHO, the over-reliance on direct sputum smear microscopy, with only about 50% sensitivity, results in many undetected TB cases. These cases are never brought into the treatment care.

Ineffective Regimens: As of 2018, the success rate of conventional treatments is only about 59%.

Extended Treatment Duration: Current TB treatments, especially for drug-resistant forms, can last up to 24 months. This makes compliance with treatment schedule difficult, ultimately leading to drug resistant TB.

Severe Side Effects: Patients often experience significant adverse effects from the long-term medication.

Drug Resistance Issues: Non-compliance and inability to tolerate the drugs contribute to the development of drug-resistant TB strains.

Limited Funding for R&D: Stop TB Partnership’s estimates the funding need for TB R&D to be US$5 billion per annum. Current commitments fall significantly short of this, making it difficult to find alternative treatments.

What are the new developments in TB treatment?

Introduction of New Regimens: At the Union World Conference on Lung Health 2023, four innovative drug regimens were presented for treating drug-resistant TB.

Effective Treatment Outcomes: These regimens showed similar efficacy to conventional treatments, with favourable outcomes for 85-90% patients.

Shorter Treatment Times: The new treatments reduce the duration by two-thirds compared to traditional methods.

Access and affordability: The new findings could address issues around access to and affordability of quality TB care.

How has research and development impacted TB drug development?

Impact of Funding: The United Nations targeted $2 billion annually for TB R&D. In 2021, the funding for R&D reached a billion dollars worldwide, for the first time.

Global Collaboration: The progress in TB drug development results from a decade of global efforts, involving organizations like WHO, Stop TB Partnership, and the Treatment Action Group.

Long-term Commitment: Continuous efforts and commitment over years have been crucial in achieving these advances, demonstrating the vital role of sustained research and development in TB care.

What is the way forward in TB treatment?

Innovative Testing and Diagnostics: The way forward includes the adoption of rapid, portable tests and AI-assisted diagnostics for enhancing early detection and treatment effectiveness.

Global Scale-up of Short Regimens: Particularly in countries like India, scaling up the 6-month shorter regimens for drug-resistant TB is essential.

Comprehensive Strategy: The goal of ‘Ending TB by 2030’ requires a multi-pronged approach focusing on better case detection, improved treatment, and continued global collaboration and funding efforts.

Question for practice:

Examine how the new drug regimens introduced at the Union World Conference on Lung Health 2023 could impact the treatment of drug-resistant tuberculosis, particularly in high-burden countries like India.