Gross mismanagement: On TB drug shortages and India’s national TB programme

Context:

India's struggle to eliminate tuberculosis (TB) by 2025, as per Prime Minister Narendra Modi's ambitious goal, is exacerbated by a recurrent shortage of TB drugs, particularly for drug-sensitive TB patients.

Shortage of TB Drugs:

• Drug shortage: India is facing a concerning shortage of TB drugs, including critical medications for drug-sensitive and multidrug-resistant TB (MDR-TB) patients, hindering treatment initiation and success.
• Questionable preparedness: With less than two years remaining to achieve the TB elimination goal, India's inability to address the most basic elements of TB control, including drug availability, raises doubts about the country's preparedness to meet its targets.
• Undermined efforts: The shortage of TB drugs undermines efforts to address gaps in the TB care cascade, such as delays in diagnosis, treatment initiation, and achieving treatment success, posing significant challenges to TB control efforts.

Inadequate Management and Response:

• Need for management: The decision to rename the National TB Control Programme as the National TB Elimination Programme without addressing fundamental issues like drug availability reflects inadequate management and seriousness in combating TB.
• Logistical challenges: Last-minute permissions granted by the Health Ministry to States for local drug procurement create logistical challenges at the field level, further exacerbating the drug shortage issue.
• Required measure: Addressing the recurrent shortage of TB drugs and improving the management of the national TB programme are crucial steps needed to enhance India's efforts towards eliminating TB by 2025.