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India faces drug shortage against rising tuberculosis cases

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After years of progress against tuberculosis, the battle against the deadly disease has hit a wall in India.

The country accounts for one-fifth of the total number of tuberculosis cases in the world, and it is now facing an acute shortage of drugs.

The lives of thousands of tuberculosis patients in India are at risk due to a severe shortage of drugs and suitable medication.

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Children are turned away from clinics – their disease left untreated, as paediatric doses run out.

Even the most common anti-tuberculosis drugs, like Rifampicin and Streptomycin, are hard to come by.

Dr JN Banavaliker, Vice-Chairman of Tuberculosis Association of India, said: “The shortage is basically because the consumption is huge and compared to the production, there is a deficit. Now, because the number is slowly increasing, the use of Streptomycin increases. Now probably that use of Streptomycin cannot compare itself to the production.”

And since there’s not enough to go around, patients often stop taking drugs while waiting for supplies to come in. As a result, they develop drug-resistant tuberculosis, which is not treatable.

Other factors, such as overcrowding, contribute to the accelerating rate of transmission of the highly infectious disease.

Dr Vivek Nangia, a tuberculosis specialist at Fortis Hospital, said: “The factors could be social from the point of view of a patient, meaning the patient is not able to afford the treatment, is not able to comply with the therapy. Sometimes they reach the doctors pretty late in the stage so diagnosis becomes a difficulty.

“Then cross transmission of infection from congested houses where there is overcrowding, overpopulating. So those are the social factors that would be responsible. Now, if you look at what WHO (World Health Organisation) classifies, the drugs that are being supplied to could also be responsible for the emergence of multi-drug resistance to TB.”

India has the highest number of tuberculosis patients in the world, according to the WHO.

And it remains the biggest infectious-disease killer of adults, with 300,000 people dying from the disease in 2011.

Doctors say the government will first need to address the drug shortage, before it can even think about winning the war against tuberculosis.

Dr JN Banavaliker added: “Increase the production. There are ways going on to increase the production of Streptomycin so that you can actually get it or to import it.”

The Indian government has initiated several programmes to combat the deadly disease in the past, but despite their sustained efforts, tuberculosis control remains at a critical juncture in India mainly due to a shortfall of drugs.

In the present circumstances, what is really needed is a sustainable solution to ensure an uninterrupted supply of anti-TB drugs before the situation turns into an epidemic.

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