Amid global call to step up TB treatment, experts flag India’s ‘conservative approach’

Experts said that India is still following a very conservative approach regarding the new medicines for drug resistant TB, putting lives of patients including children in danger. Scaling up of new DR-TB drugs — Bedaquiline and Delamanid — is needed even more during Covid-19.

4 min readPuneUpdated: Nov 17, 2020 11:32 AM IST

As the COVID-19 pandemic threatens to derail the global response to tuberculosis (TB), Médecins Sans Frontières/Doctors Without Borders (MSF) has called on governments to accelerate testing, treatment, and prevention for TB, and for donors to provide financial support to ensure increased access to new medical tools for diagnosing and treating millions with this disease.

Experts said that India is still following a very conservative approach regarding the new medicines for drug resistant TB, putting lives of patients including children in danger. Scaling up of new DR-TB drugs — Bedaquiline and Delamanid — is needed even more during Covid-19.

EXPLAINED

Amid pandemic, need to maintain TB services continuity

While reporting on the severe impact of the Covid-19 pandemic on TB services, WHO revealed a sharp drop in the number of people diagnosed. Besides needing to catch up to maintain continuity of existing TB services, it advised countries to adopt better testing policies and practices. Countries still fall short on rolling out up-to-date testing policies that can assist in reaching nearly 3 million people being missed.

Until March 2020, India had 1,19,960 MDR-TB patients who were eligible for Bedaquiline. However, only 10,845 had received it. Hence, 1,09,115 patients were not given this medicine, even as India is home to a quarter of the world’s DR-TB patients, according to sources.

A report released on Monday by MSF and the StopTB Partnership — Step Up for TB — surveys 37 high TB-burden countries and shows that critical medical innovations are reaching far fewer people who urgently need them, because many countries continue to lag in getting their policies in line with new World Health Organization (WHO) guidelines. MSF officials said Covid-19 has worsened their plight.

TB remains the world’s top infectious disease killer, with more than 10 million people falling ill and 1.4 million people dying due to this disease in 2019.

National treatment programmes must prioritise use of all-oral treatment regimens for people with drug-resistant TB (DR-TB) that no longer include older, toxic drugs that have to be injected and cause serious side effects.

The report finds that only 22% of countries surveyed allow TB treatment to be started and followed up at a primary healthcare facility, instead of travelling to a hospital, for instance, and for medicines to be taken at home. Additionally, 39% do not use a modified all-oral shorter treatment regimen and 28% of countries surveyed still are using injectable medicines when treating children with DR-TB.

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“Instead of stepping up for TB, we are at risk of slipping back due to COVID-19,” said S Lynch, Senior TB Policy Advisor for MSF’s Access Campaign. “We cannot stress enough how urgent it is now for governments and donors to intensify their efforts so That critical medical innovations and tools reach people with TB. We finally have better drugs and tests to tackle and prevent this extremely infectious yet curable disease, so it’s both mind-boggling and unacceptable that they’re still not being used to save as many lives as possible.”

As highlighted in the report, 85% of countries surveyed do not use the lifesaving point-of-care urinary TB LAM test for routine diagnosis of TB in people living with HIV, as recommended by WHO.

“As clinicians working on the frontlines of the TB epidemic, it is distressing to see the sluggish uptake of TB LAM (urine lipoarabinomannan assay) in national treatment programmes, despite its proven role in saving lives of people living with HIV,” said Dr Patrick Mangochi, Deputy Medical Coordinator for MSF in Malawi.

Anuradha Mascarenhas

Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune. With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments. She also takes a keen interest in covering women's issues . Professional Background Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature. Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr. Soumya Swaminathan, the former Chief Scientist at the WHO. Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives. Awards and Recognition Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024). A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021. Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards. She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.” Recent Notable Articles (Late 2025) 1. Cancer & Specialized Medical Care "Tata Memorial finds way to kill drug-resistant cancer cells" (Nov 26, 2025): Reporting on a breakthrough for triple-negative breast cancer, one of the most aggressive forms of the disease. Discipline, diet and purpose; How a 97-year-old professor defies ageing'' (Nov 15, 2025) Report about Prof Gururaj Mutalik, the first Head of Department at Pune's B J Government Medical College who at 97 credits his longevity to healthy habits and a strong sense of purpose. 2. Environmental Health (The "Breathless Pune" Series) Long-term exposure even to 'moderate' air leads to chronic heart, lung, kidney issues" (Nov 26, 2025): Part of an investigative series highlighting that even "safe" pollution levels are damaging to vital organs. "For every 10 µg/m3 increase in PM2.5 level, there was 6-8% jump in medicine sales" (Nov 23, 2025): Using commercial data to prove the direct link between air quality and respiratory illnesses in Pune. 3. Lifestyle & Wellness News "They didn't let cancer, diabetes and heart disease stop them from travelling" (Dec 22, 2025): A collaborative piece featuring survivors who share practical tips for traveling with chronic conditions. At 17, his BP shot up to 200/120 mmHG; Lancet study flags why child and teen hypertension doubled between 2000 and 2020'' (Nov 12,2025)--A report that focusses on 17-year-old-boy's hypertensive crisis and reflects the rising global trend of high blood pressure among children and adolescents. 4. Scientific Recognition & Infrastructure For promoting sci-comm, gender diversity: IUCAA woman prof highlighted in Nature" (Nov 25, 2025): Covering the global recognition of Indian women scientists in gender studies and physics. Pune researchers find a spiral galaxy like the Milky Way from early universe'' (December 3, 2025)- A report on how Indian researchers discovered a massive galaxy that existed when the universe was just 1.5 billion years old , one of the earliest to have been observed so far. Signature Beat: Health, Science & Women in Leadership Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials. She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields. Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions. ... Read More

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