Times of India
By Kounteya Sinha
New Delhi

Patients Taking Substandard Drugs Can Develop Resistance
Drug resistant TB — the type that does not respond to the most effective anti-TB drugs available — is fast sweeping through the world. And what’s worse, India and China are home to 50% of the globe’s multi-drug resistant TB (MDR TB) cases.

According to WHO’s global report on drug resistant TB released on Friday, an estimated 4.4 lakh people globally got infected with MDR TB in 2008 while 1.5 lakh died of it. Worldwide, there were an estimated 9.4 million cases of new TB cases in 2008 with 1.8 million deaths. India estimates that 3% of all new TB cases in the country is the type that can no longer be treated with standard drug regimens.

Progress as far as treatment is concerned remains slow in most countries. Worldwide, of those patients receiving treatment, 60% were cured. However, only an estimated 7% of all MDR-TB patients are diagnosed.

MDR TB has several issues that can prove highly problematic for India. As against the 6-month treatment regimen for normal TB, MDR TB treatment can take up to two years or more to treat with drugs that are less potent and more toxic.

Economically, dealing with MDR TB is a big blow for the programme. Drugs for drug resistant TB are highly expensive — 50 to 200 times higher. While a course of standard TB drugs costs $20, MDR TB drugs can cost up to $5,000.

Meanwhile, the worst form of drug resistant TB — the extreme type popularly referred to as XDR — is also raising its head much more frequently than before. WHO estimates there may be around 25,000 XDR TB cases a year with most proving fatal. Since XDR TB was first defined in 2006, a total of 58 countries have reported at least one case of this strain till 2008.

WHO also pointed to the fact that there was an urgent need to expand and accelerate diagnosis capabilities in countries and have technology that could diagnose MDR TB in two days rather than traditional methods which can take up to four months. Drug-resistant TB usually arises when people are poorly treated or take substandard medicines. Not all countries have the surveillance systems to pick up cases of XDR TB.

“The funding required for MDR TB control in 2015 will be 16 times higher than the funding that is available in 2010,” the WHO report said.