The Foundation for Innovative New Diagnostics (FIND) has announced a new initiative, supported by Johnson & Johnson, which will help build and strengthen the capacity of at least seven tuberculosis (TB) culture and drug-susceptibility testing (C&DST) facilities in India, in collaboration with the country’s Revised National Tuberculosis Control Programme (RNTCP).
FIND will work closely with state-level officials to establish and enhance the capacity of TB C&DST laboratories in the high-burden TB states of Maharashtra, Himachal Pradesh and Tamil Nadu.
TB is the world’s deadliest infectious disease and in India, a person dies of TB every minute. Growing resistance to the most commonly-used drugs is compounding this public health challenge.
India saw nearly 135,000 new cases of drug-resistant TB in 2018, more than any other country. Globally, only one in three people with drug-resistant TB is diagnosed and put on treatment and, of those, only 56 per cent are successfully cured.
To address this significant health challenge, the RNTCP has established the National Strategic Plan (NSP) 2017-2025, with the goal of eliminating TB in India by 2025. The NSP emphasises the need for expansion and strengthening of C&DST laboratory capacity, in order to pave the way for universal access to quality TB and drug-resistant diagnosis.
C&DST laboratories are crucial for diagnosis involving extended drug susceptibility testing, including for newer drugs, along with detection of TB in extra-pulmonary samples.
The World Health Organisation (WHO) recommends the establishment of at least one TB C&DST laboratory per 10 million people. Given India’s population, this involves setting up 125-130 laboratories in the country.
Since 2010, FIND has been a key technical and implementing partner of India’s RNTCP for the nationwide laboratory network for drug-resistant diagnostic services. FIND has supported the establishment of all 61 of the country’s current C&DST laboratories, and ensured sustained service delivery in these laboratories through management of reagent supplies and maintenance of equipment.
While 20 more C&DST laboratories are currently in the pipeline in India, at least 25-30 more need to be set up to meet WHO targets and achieve the NSP goal.
Several states in the country are keen to fund the upgrade of current laboratory infrastructure so that they are C&DST-enabled.
“Achieving India’s ambitious TB goals depends not just on finding those with the disease, but also ensuring they can be treated with drugs that will work, and for this access to C&DST facilities is essential,” said Dr Sarabjit S Chadha, regional technical director, FIND India and South-East Asia region.
The Centre has planned a laboratory upgrade project that can increase tuberculosis testing capacity. If a laboratory has the capacity to test approximately 9,000 samples for tuberculosis every year, it will increase the testing capacity by at least six times that number, said Dr K S Sachdeva, deputy director-general of the Revised National Tuberculosis Control Programme.