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</o:shapelayout></xml><![endif]--></head><body lang=EN-IN link=blue vlink=purple><div class=WordSection1><p class=MsoNormal align=center style='text-align:center'><span style='font-size:14.0pt;font-family:"Times New Roman","serif"'>India must address worrying stock out of tuberculosis drugs<o:p></o:p></span></p><p class=MsoNormal align=center style='text-align:center'><i><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><o:p> </o:p></span></i></p><p class=MsoNormal align=center style='text-align:center'><i><span style='font-family:"Times New Roman","serif"'>Indian government drug tender process leads to deadly delay in drug supply<o:p></o:p></span></i></p><p style='margin:0cm;margin-bottom:.0001pt'><i><span lang=EN-GB><o:p> </o:p></span></i></p><p style='margin:0cm;margin-bottom:.0001pt'><i><span lang=EN-GB>New Delhi, 17 June 2013</span></i><span lang=EN-GB> – 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.<o:p></o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB><o:p> </o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB>"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.” <o:p></o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB><o:p> </o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB>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. <o:p></o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB><o:p> </o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB>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. <o:p></o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB><o:p> </o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB>“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.”<o:p></o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB><o:p> </o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB>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.<o:p></o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB><o:p> </o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB>“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.”<o:p></o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB><o:p> </o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB>“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.”<o:p></o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB><o:p> </o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB>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. <o:p></o:p></span></p><p style='margin:0cm;margin-bottom:.0001pt'><span lang=EN-GB><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Times New Roman","serif"'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Times New Roman","serif"'>Leena Menghaney<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Times New Roman","serif"'>Manager (India)<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Times New Roman","serif"'>Access Campaign<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Times New Roman","serif"'>Medecins Sans Frontieres<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Times New Roman","serif"'>First Floor, C 236 Defence Colony, New Delhi, 110 024<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Times New Roman","serif"'>Tel: +91 11 46573730, <o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Times New Roman","serif"'>Telefax: +91 11 46573731<o:p></o:p></span></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><o:p> </o:p></p></div></body></html>