Drug resistant tuberculosis (TB) is on the rise, threatening to make an already deadly disease near untreatable. While India may be formulating plans to combat the disease, is it providing the financial backing to make them a possibility?
TB is causing ever more concerning headlines. 10.4 million new cases of TB were noted by the World Health Organization (WHO) in 2015, with 1.8 million deaths associated with the condition. These figures are only likely to rise as the disease becomes more difficult to treat.
India accounts for a disproportionately large percentage of global TB deaths, with around 500,000 deaths annually. India is also a breeding ground for drug resistance, with an estimated 480,000 new instances of drug resistant TB arising within the country each year.
India does have measures in place to address the situation, with a Central Tuberculosis Division within the the Indian government. The division has made TB a notifiable disease, as well as established guidelines and standards for treatment, along with molecular and drug-susceptibility testing.
Despite these efforts huge numbers of new TB cases are still reported within the country. Drug resistant TB is increasing at a considerable rate. The situation will require more than just more stringent guidelines. It is likely to require considerable financial investments in the near future. Without them drug resistance will become so common that the disease will be almost unmanageable, resulting in considerable loss of life.
The trend towards drug resistance has been going on for decades claims a study recently posted in Bio-Med Central (BMC) Public Health. The study pools together data from investigations spanning two decades, from 1995 to 2015. It found the prevalence of drug resistance had risen from 37.7 percent between 1995 and 2005 to 46.1 percent between 2006 and 2015. 75 selected studies were analysed and an average was taken.
Region specific data indicated many areas saw rates considerably higher than the 57.8 percent average seen across West India. The authors of the study note that in highly crowded, urban environments, transmission rates of TB were higher, allowing any instance of drug resistant TB to spread at faster rates.
More medications need to be created to address the growing issue of drug resistance. The technical group on tuberculosis in the ministry of health has given approval to Delamanid, a drug created for the purpose of combating multi-drug resistant TB. The drug is currently in phase III human trials, though has been documented to have positive results in trials conducted in South Africa and Japan.
Bedaquiline is also known to be effective against drug resistant strains. However, the drug is known to have potentially lethal side effects. The treatment is only available in Mumbai, Delhi, Guwahati, Chennai and Ahmedabad. This highlights another key concern over efforts in India to combat TB. Treatments are inconsistent depending on the region, which will often allow many in areas with lower access to healthcare services to spread drug resistant strains further.
If India is to effectively combat drug resistant TB, it will need to provide uniform, quality treatment across the nation. Alongside this, the efforts against the disease need to benefit from increased financial backing.