PHM-Exch> India must address worrying stock out of tuberculosis drugs - Indian government drug tender process leads to deadly delay in drug supply

[Leena Menghaney]

India must address worrying stock out of tuberculosis drugs

 

Indian government drug tender process leads to deadly delay in drug supply

 

New Delhi, 17 June 2013 – The Indian government must urgently address the
persistent issues and almost routine delays of procuring drugs to treat
tuberculosis, international medical humanitarian organisation Médecins Sans
Frontières (MSF) said today. The issues are behind a worrying stock out of
TB drugs which the country is currently experiencing.

 

"As a country with such a high burden of tuberculosis, MSF is deeply
disturbed that India is experiencing stock outs of critically needed drugs
to treat children and those with drug-resistant TB”, said Leena Menghaney,
India Manager of MSF’s Access Campaign. “In this instance, it’s a stock out
that can cost people’s lives and the government must act urgently to fix the
problems.” 

 

India is currently experiencing stock outs across the country of both
paediatric TB drugs and those used to treat drug-resistant TB (DR-TB). Under
India's public TB treatment program, the government is responsible for
buying drugs and distributing them to the states which then provide
treatment. 

 

The stock out is related to the never-ending issues with drug procurement
that India faces in many of its public health programmes - the routine but
deadly delay in tendering for these drugs - and the resulting drug stock
outs are one of the reasons why India has one of the world's highest burdens
of DR-TB. 

 

“As a TB treatment provider, MSF is witnessing the impact this is having on
our own patients”, said Dr. Homa Mansoor, the TB Medical Referent for MSF
India. “In our Mon, Nagaland project, I’ve seen a 12 year-old girl on
treatment arrive with her father after a long journey to get her medicine.
The medicines were out of stock, but luckily we had six days’ worth of drugs
available from a patient who had died. Otherwise, we’re having to resort to
breaking adult pills to give to children, which is really dangerous as it
could over- or under-dose them.”

 

Other patients have been forced to purchase medicines from private
pharmacies, but have received lower-dosage drugs, which – if it causes a
patient to under-dose on that drug – could lead to resistance.

 

“A continuous, sustainable supply of quality-assured medicines is vital for
TB patients to have even half a chance of being cured”, Dr Mansoor said. “As
a doctor, I know the disease, I know how to manage it, but I feel powerless
because we don’t have the medicines to treat.”

 

“It’s just not good enough that India talks of scaling up DR-TB treatment,
but finds the medicine cabinet empty at a time when the most vulnerable
patients – those diagnosed with DR-TB - are most desperate to get the
medicines that can treat them”, Dr Mansoor added.  “The Indian Government
must act now to address this dire situation.”

 

The stock outs in India are occurring as the World Health Organization late
last week issued interim guidelines on bedaquiline, the first new drug to
treat TB in 50 years, approved by the US Food and Drug Administration at the
end of 2012. MSF has welcomed the release of the guidelines, but has said
use of the new drug needs to be regulated and controlled, and studies must
be undertaken to find combinations with the new drugs in shorter, more
effective and less toxic treatment regimens. 

 

 

Leena Menghaney

Manager (India)

Access Campaign

Medecins Sans Frontieres

First Floor, C 236 Defence Colony, New Delhi, 110 024

Tel: +91 11 46573730, 

Telefax: +91 11 46573731

 

 

 

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