Médecins Sans Frontières (MSF; Doctors Without Borders) has strongly urged the Indian government to address ongoing shortages of pediatric TB drugs and medicines used to treat drug-resistant TB (DR-TB). Under current policy, the Indian central government purchases TB drug supplies and distributes them to the states, which are responsible for providing treatment to TB-infected patients. However, TB drugs routinely are out of stock, which is one reason India has such high incidence of DR-TB, according to Leena Menghaney, India manager of MSF’s Access Campaign.
Dr. Homa Mansoor, TB medical referent for MSF India, explained that if pediatric TB medicines were unavailable for children who had travelled long distances to obtain treatment, doctors had to resort to “breaking adult pills,” which could result in an incorrect dose. Other desperate patients have purchased lower-dose TB medications from retail pharmacies, since proper dosages were not available to them through government sources. Drug resistance can develop in under-dosed patients.
The World Health Organization released interim guidelines for use of bedaquiline, which the US Food and Drug Administration approved for TB treatment in 2012. MSF recommended strict regulation and control of new drugs and studies to determine more effective drug combinations that might be taken for shorter duration with less toxicity.