On the eve of World TB Day - March 24, 2010 - the Indian Network for People living with HIV (INP+), in partnership with the ACTION (Advocacy to Control TB Internationally) project and Global Health Advocates have brought out results of the first of its kind study on barriers to accessing TB treatment services among people living with HIV, injecting drug users (IDU) and the general population. This year, 2010, is also declared as Year of the Lung. Read more
The study conducted in Imphal, Manipur and Erode, Tamil Nadu highlights the lack of penetration of TB control services among vulnerable populations. The study lead author Dr Venkatesan Chakrapani, Policy and Research Adviser, INP+, says: "The gap of knowledge among people living with HIV/AIDS of this key co-infection contributes directly to their higher mortality. Early treatment can avert a majority of these deaths. Newer technology is crucially required to diagnose the problem of drug resistance among both the general population and among people living with HIV."
Affordable, faster diagnostics and treatment for TB the most important research and development required, says Dr SK Brahmachari, Director General, Council of Scientific and Industrial Research (CSIR). CSIR says that the combination of an ayurvedic ingredient with the current drug regime have shown enhanced effectiveness of TB treatment in currently ongoing clinical trials.
Among the people who spoke at the release on the need for innovation and research to tackle TB were Dr SK Brahmachari, Director General, CSIR, and Dr Jayanth Banavaliker, Medical Superintendent of the Rajan Babu Institute for Pulmonary Medicine and Tuberculosis (formerly RBTB Hospital), New Delhi.
Releasing the report on behalf of ACTION Project and INP+, Dr SK Brahmachari, DG, CSIR said it is a commendable job done. He added that, "There is a huge challenge, how to develop more specific diagnostics and treatment which is affordable and detects quickly. This is the most important research and development required."
Commenting on the need for more rapid and effective treatment for TB, Prof SK Brahmachari, DG, CSIR said that clinical trials have shown that the combination with Pepperine (an ayurvedic extract) in one of the TB drugs not only makes the treatment more effective with half the current dosage but also cheaper by nearly 23%. This combination is expected to have fewer side-effects and prevent reoccurrence, with specific benefits for women.
"With more and more people reporting drug resistance, it is imperative that newer technologies are adopted to make early diagnosis of drug resistance a reality," says representatives from Global Health Advocates (GHA), one of the advisors on this study. "All the gains from having a national TB control effort can be decimated by the problem of drug resistance. This is the tipping point of the battle against TB in India, and we need new ways of diagnosing people with TB", GHA representative adds.
Discussing the intensity of tuberculosis in India, Dr Banavaliker stressed, "Tuberculosis is curable and the disease can be contained if managed adequately throughout. Early initiation and proper treatment is the best prevention of tuberculosis and resistant TB."
"In-as-much that drugs, diagnostics and research are going to be critical to TB control, we need to have far more involvement of civil society and a greater engagement of political will. TB must be taken on wholeheartedly and comprehensively by society and politicians if we are to avert an MDR crises," said Vivek Dharmaraj of the Advocacy to Control TB Internationally (ACTION) project.
TB remains one of the greatest public health challenges. Paradigm shifts in thinking are urgently needed. Across the world innovative approaches are being initiated to tackle TB. Massive investment in new drugs, rapid and robust diagnostic tools and research is imperative.
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