Need for new, shorter treatment regimens for drug-resistant TB

Source: The post need for new, shorter treatment regimens for drug-resistant TB has been created, based on the article “Sharpening India’s anti-tuberculosis fight” published in “The Hindu” on 29th August 2024

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

Context: The article discusses India’s struggle with tuberculosis (TB) and emphasizes the need for new, shorter treatment regimens for drug-resistant TB. It highlights the benefits of using the WHO-recommended BPaL/M regimen, improving diagnostics, and targeting at-risk populations to enhance TB detection and treatment.

For detailed information on Tuberculosis- Role of private sector in Elimination read this article here

What is the current TB situation in India?

1. India bears over a quarter of the global tuberculosis (TB) burden.
2. In 2023, efforts to tackle ‘missed’ TB cases resulted in 25.1 lakh patients being diagnosed.

What are the challenges with current TB treatment regimens?

1. Lengthy Treatment Duration: Current regimens require 9 to 24 months of treatment, causing physical and psychological strain on patients.
2. High Pill Burden: Patients must take 13-14 tablets daily for shorter regimens and 4-5 tablets for longer regimens.
3. Severe Side Effects: Treatment can cause hearing loss, psychosis, and other debilitating side effects.
4. Economic Impact: Extended treatment often leads to job loss, driving families into poverty.
5. Low Success Rates: The current treatment success rate in India is only 68%, compared to 89% with the new BPaL/M regimen.

What New Treatments Are Available?

1. India is set to introduce the WHO-recommended BPaL/M regimen for drug-resistant TB.
2. The BPaL/M regimen requires only three to four tablets daily for six months.
3. This regimen is more effective, with an 89% success rate, compared to the 68% success rate of current treatments.
4. The BPaL/M regimen reduces severe side effects, such as hearing loss and psychosis.
5. Implementing BPaL/M can save health systems up to $740 million annually.
6. This regimen is already adopted by about 80 countries, with 20 high-burden countries rolling it out.

How Can TB Diagnosis Be Improved?

1. Use GIS Mapping and Health Data: Identify vulnerable populations like those with malnutrition, diabetes, HIV, and former COVID-19 patients for targeted screening.
2. Conduct Multi-Disease Screening: Focus on at-risk communities, including slum residents, prisoners, and homeless individuals, to detect TB early.
3. Leverage Technology: Portable X-ray machines with AI-driven tools can reduce diagnostic delays, especially in remote areas. For example, chest X-rays detected 42.6% of TB cases in the National TB Prevalence Survey (2019-21).
4. Adopt Rapid Molecular Tests: These tests provide faster and more accurate TB detection than traditional microscopy methods.

Question for practice:

Examine the challenges associated with current tuberculosis (TB) treatment regimens in India and how the introduction of the WHO-recommended BPaL/M regimen could address these challenges.