This article discusses the critical issue of anti-TB drug stock-outs in India, specifically within the National Tuberculosis Elimination Program (NTEP).
Here’s a breakdown of the key points:
The Problem:
Drug Stock-outs: A significant drug stock-out occurred during 2023-24, affecting almost all states in India and impacting both drugs for Drug-Sensitive TB (DS-TB) and Drug-Resistant TB (DR-TB). Impact on Patients (PwTB):
Patients had to “run from pillar to post” to get their daily medications.
those who could afford it bought drugs from the open market.
DR-TB patients, who rely solely on NTEP for their drugs, were forced to take incomplete regimens or miss doses.
consequences of Missed/Incomplete Doses:
Delays in cure or no cure at all.
Increased risk of developing drug resistance. Higher out-of-pocket expenditure for patients.
Erosion of trust in government health systems.
Hindrance to the national goal of TB elimination.
The Proposed Solution and its Caveats:
Restricting Newer Drugs to NTEP: The article acknowledges the proposition to make newer anti-TB drugs accessible only thru NTEP.
Crucial Condition: This move is welcomed provided the government ensures a reliable and uninterrupted supply of drugs through the programme.
Recommendations for Improvement:
Public access to Drug Stock Data: Make the “Ni-Kshay Aushadhi dashboard” (showing drug stock availability) publicly accessible,similar to the Ni-Kshay dashboard for disease burden. This would:
Ensure accountability.
Help public health advocates forecast and flag potential stock-outs.
Civil Society Vigilance: High vigilance from civil society is needed to predict,prevent,or mitigate regional stock-outs.
Leveraging Local Governance: The “TB Mukt panchayat initiative” could be used to involve local self-governments (gram panchayats) in monitoring drug availability.
* Commitment from Leadership: Accountability in drug provision requires dedication from those in power.
Conclusion:
The restriction of newer anti-TB drugs to NTEP should only be implemented after careful planning and adequate groundwork to prevent any interruption in access for eligible individuals.The recent stock-outs highlight the severe consequences of supply chain failures and the need for robust systems to ensure continuous access to essential TB medications.
