Date:15/12/2007 URL: http://www.thehindu.com/2007/12/15/stories/2007121562351300.htm

National

Drug-resistant TB a major challenge, says Anbumani

Special Correspondent

Asks health practitioners to discourage irrational use of drugs

Anbumani Ramadoss

NEW DELHI: Terming drug-resistant tuberculosis a major challenge, Union Health and Family Welfare Minister Anbumani Ramadoss on Friday asked health practitioners to discourage irrational use of first and second line drugs.

Speaking at the 62nd National Conference on Tuberculosis and Chest Diseases (NATCON), organised by the Tuberculosis Association of India here, Dr. Ramadoss asked health experts to develop a vaccine and sought the help of the international fraternity in this.

He said health practitioners should follow the Revised National Tuberculosis Control Programme (RNTCP) guidelines for diagnosis and treatment and ensure good quality Directly Observed Treatment, short-course (DOTS) services to prevent drug resistance.

Pointing out that India had the highest number of TB cases – one in five new cases in the world – he said a major challenge to RNTCP was the emergence of multi-drug resistant (MDR) and extensively drug resistant (XDR) tuberculosis.

Improving quality of treatment

As per the community-based drug resistance surveillance (DRS) conducted in Gujarat and Maharashtra, it was about three per cent among the new cases. And, the most effective means of preventing further resistance was by maintaining and improving the quality of treatment and, more importantly promoting rational use of anti-TB drugs.

The national programme initiated the DOTS plus services for management of MDR-TB in Gujarat and Maharashtra in early 2007.

This would be introduced in other States in a phased manner by 2009-10.

Similarly, TB/HIV coordination activities implemented jointly by the RNTCP and National AIDS Control Programme would be scaled up to cover 14 States.

Quantum jump

There was a quantum jump in the number of cross referrals between the two programmes.

A 10-point counselling tool on TB was developed by RNTCP for use by counsellors in the Voluntary Counselling and Testing Centres.

Dr. Ramadoss said RNTCP was implementing the 2006 global strategy to prevent TB and reach the TB-related targets of the Millennium Development Goals (MDGs) by 2015.

However, one of the important challenges was sustaining the basic DOTS services for the next several years with systems in place to enhance the quality and reach of the programme.