THE GIST of Editorial for UPSC Exams : 19 August 2019 (Taking on TB: On new anti-tuberculosis drug (The Hindu))

Taking on TB: On new anti-tuberculosis drug (The Hindu)

Mains Paper 2: Health
Prelims level: MDR-TB, XDR-TB
Mains level: TB eliminations process

Context

•  The anti-tuberculosis drug pretomanid was recently approved by the US FDA. It will be a game-changer for treating people with extensively drug-resistant TB (XDR-TB) and those not tolerating multidrug-resistant TB (MDR-TB) drugs available at present.

TB scenario in worldwide

•  According to WHO, in 2017, there were an estimated 4.5 lakh people across the world with MDR-TB, of which India accounted for 24%, and about 37,500 with XDR-TB.

Background of the new drug

•  Pretomanid is only the third drug in the last 40 years to get FDA approval.
•  It is an all-oral, three-drug regimen of bedaquiline, pretomanid, and linezolid (BPaL).
•  It had a 90% cure rate in a phase III trial in South Africa; against the current treatment success rate for XDR-TB and MDR-TB at 34% and 55%, respectively.
•  It was found to be safe and effective in curing TB in people living with HIV.
•  Unlike 18-24 months needed to treat highly-resistant TB using nearly 20 drugs, the BPaL regimen took just six months.
•  It was better tolerated and more potent in clearing the bacteria. The shorter duration is more likely to increase adherence to therapy and improve treatment outcomes.
•  The number of those who would need a pretomanid-based regimen is increasing due to rising drug resistance.

Key Challenges

•  There are only a low percentage of MDR-TB cases being treated and the actual number of people who do not tolerate or respond to available MDR-TB drugs is unknown.
•  It remains to be seen if it would be made affordable, in the developing countries where the burden of XDR-TB and MDR-TB is the highest. Bdaquiline’s prohibitive cost has severely restricted access in developing countries.
•  TB Alliance, a New York-based international NGO, which developed and tested the drug, has signed an exclusive licensing agreement with a generic-drug manufacturer for high-income markets.
•  The drug will be licensed to multiple manufacturers in about 140 low- and middle-income countries, including India.

Conclusion

•  After all, there is a compulsion to keep the prices low and increase treatment uptake to stop the spread of highly drug-resistant TB bacteria.
•  Studies have shown an increase in the number of new patients who are directly infected with drug-resistant bacteria.

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Prelims Questions:

Q.1) With reference to the Elephants, consider the following statements:
1. The census of elephants in India is undertaken at the national level once every four years.
2. African elephants are listed as “vulnerable” and Asian elephants as “endangered” in the IUCN Red List of threatened species.
Which of the statements given above is/are correct?
a) 1 only
b) 2 only
c) 1 and 2 only
d) All the above

Correct Answer: B
Mains Questions:
Q.1) To what extent keeping the prices of the new drug low is essential for increased treatment uptake. Critically examine the statement.