70,000 TB patients in India require quality treatment: WHO

“In the Southeast Asian region there are an estimated 150,000 MDR-TB patients, of which 70,000 are in India alone.”

“What India needs is quality second-line drugs to treat these patients who develop resistance to the first-line drugs,” she said.

MDR-TB is a totally man-made problem as people either take incorrect treatment or don’t complete it, Nair said.

“TB could be easily cured if a patient takes the right drug regimen for six months regularly,” she said.

India is home to over 3.4 million tuberculosis patients – about one-fifth of the global figure – making it the most TB prevalent country, according to a WHO report “Tuberculosis in the Southeast Asia Region” released recently.

Apart from India, WHO considers countries like Bangladesh, Bhutan, North Korea, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor as part of the Southeast Asia region.

The whole region recorded 149,698 MDR-TB cases in 2006.

Nair said the need is to have enough manufacturers to produce quality second-line drugs. “It is important that the produce of the raw material is also increased so that capacity automatically goes up,” he said.

“India has strong pharmaceutical companies. But the need is to have labs that produce quality drugs,” Nair said.

WHO has a pre-qualified protocol for a pharma company which wants to manufacture such drugs.

The quality check starts from assessment of the raw material and ends at the chemist shops where the drugs are finally sold.

As per norms, experts take a look at the processing unit and after they are satisfied with the drug sample, they give them a go-ahead to produce the medicine in bulk.

But the experts continue their vigil. After the drug is prepared, they conduct further quality checks. After the drug reaches the chemist shops, another check is conducted to assess whether the drugs have degraded before their expiry date, she said.

Jai P Narain, WHO director, communicable diseases, said the need for quality second-line drugs was identified after a study was conducted in Mumbai a few years ago where it was found that patients were getting different drugs to treat tuberculosis, resulting in a person developing MDR-TB.

He said India has taken a public-private initiative under which the government provides six months drugs to private practitioners who treat tuberculosis patients.

“Under this initiative, the doctor gives a commitment that he or she would ensure that the complete treatment would be provided to a person,” he added.

Under DOTS (Directly Observed Treatment, short course), the government provides free treatment to TB patients. But he said there is a need to maintain, strengthen and improve the quality of DOTS implementation across a population of almost 1.2 billion.