Context:
Prime Minister Narendra Modi put new vigour into the global tuberculosis (TB) eradication response at the One World TB Summit in Varanasi, Uttar Pradesh on March 24, 2023, and underlined India’s resolve to spearhead this endeavour.
Tuberculosis:
- Mycobacterium tuberculosis is the bacteria that cause tuberculosis (TB). TB germs often attack the lungs, but they can affect any region of the body, including the kidney, spine, and brain.
- Transmission:
- Tuberculosis spreads through the air from person to person. When persons with lung tuberculosis cough, sneeze, or spit, the TB germs are released into the air.
- Every age group is at risk. More than 80% of illnesses and fatalities occur in low- and middle-income nations.
- Symptoms:
- Cough with mucus and blood at times, chest pains, weakness, weight loss, fever, and night sweats are all common signs of active lung TB.
- Treatment:
- Tuberculosis is a treatable and curable illness. Drug-susceptible tuberculosis is treated with a normal 4-month or 6-month course of four antimicrobial medicines, with patient assistance given by a health worker or certified treatment supporter.
- Two most effective first-line drugs: isoniazid and rifampicin.
- For drug-resistant tuberculosis (DR-TB): Bedaquiline
India’s initiatives to end TB:
- India has made tremendous advancement in its attempts to eradicate tuberculosis in recent years.
- The National Tuberculosis Elimination Programme (NTEP) in India (formerly known as the Revised National Tuberculosis Control Programme, or RNTCP) has implemented many strategies to detect, notify, and treat TB infections, with case notifications increasing from 15.6 lakh in 2014 to over 24 lakh in 2022. This reflects the program’s broader reach and enhanced detection methods.
- Furthermore, newer initiatives like as collaboration with the commercial sector, the establishment of social support provisions, and the development of diagnostic equipment and new treatment regimens have improved TB management.
- To overcome this problem and effectively improve the TB response efforts, innovative techniques and new tools to be implemented to revolutionise the way of prevention, diagnosis and treatment of TB.
- In recent years, India has understood the need of investing in health research and development. The Mission COVID Suraksha vaccine development initiative was an excellent example of a public-private cooperation with clear aims and achievements. The large number of diagnostic tests created and the variety of vaccination platforms demonstrate that our manufacturing industry is resilient and scalable.
- It is also encouraging to see the formation of centres of excellence, which will promote collaboration between laboratories of the Indian Council of Medical Research and the private sector.
- It is therefore feasible to boost and extend TB research and development activities, as well as create new instruments that will assist India (and other developing nations) in meeting the End TB objectives.
Three key areas:
- Vaccination:
- To begin, a vaccination is what allows for the eradication of any infectious disease. Existing TB vaccine, the Bacille Calmette-Guérin (BCG), does not fully protect adolescents and adults, who are most at risk of getting and transmitting TB.
- There are now over 15 TB vaccine candidates in the pipeline; it needs to be ensure that clinical trials to determine effectiveness in diverse community contexts and for different target groups are prioritised.
- Testing and diagnosis:
- Testing for and diagnosing tuberculosis must become more accessible and inexpensive, such that anybody with suggestive symptoms or a frontline worker may test and receive findings in minutes at a low cost.
- Point-of-Care Tests (POCTs), such as home-based COVID tests, enabled decentralised, quick, and low-cost diagnostics with findings in minutes.
- New developments, such as nasal and tongue swab-based testing for tuberculosis, have the potential to alter the game by minimising diagnostic delays.
- Introduction of new therapeutic molecules:
- Third, in the long run, the creation and launch of novel therapeutic substances can be critical. While continue to invest in drug research, newer and more effective regimens must be scaled up, as well as delve into the arsenal to repurpose current medications for tuberculosis.
Issues:
- While these efforts are admirable, a lack of general knowledge of the condition and access to adequate care remains an issue.
- According to the most recent National Tuberculosis Prevalence Survey (in India), 64% of patients with infectious tuberculosis did not seek treatment. As a result, national-level statistics indicate that for every individual diagnosed with tuberculosis, detection of almost two more cases is missed.
Way forward:
- Creating legislative and policy frameworks that smooth the distribution of proven technologies to reach people with the least amount of delay is also part of the process of improving the innovation ecosystem.
- Greater collaboration is required, not just among politicians, scientists, product manufacturers, and clinical researchers within the country and even between regions, but also possibly across governments.
- Harmonisation of standards and regulatory processes across nations can allow for mutual recognition of evidence-based norms and licences, as well as saving important time in the rollout process.
Source: The Hindu, WHO