Treating MDR-TB

In News: The Delhi High Court acceded to the plea of a girl that she must be given access to Bedaquiline, an anti-TB drug to treat multi-drug resistant disease (MDR-TB).

  • Bedaquiline’s availability is restricted to just five cities. Since the girl was not residing in the five cities, her domicile status was held against her from being treated with Bedaquiline.

Why Bedaquiline is Restricted?

  • Bedaquiline was the first major anti-TB drug discovered in the last 40 years.

  • The govt restricted its use because of the fear that mycobacterium might develop resistance to the medicine.

  • In India, around 99,000 new cases of MDR-TB are notified. But, only 164 patients are enrolled for Bedaquiline therapy.

  • The rampant use of anti-TB medicines had resulted in 4.80 lakh new cases of MDR TB in 2015.

Lacunae in Managing MDR-TB

  • Joint TB Monitoring Mission in its report had pointed out the lacunae within the Revised National Tuberculosis Control Program (RNTCP) in the management of MDR-TB cases.

  • The high power committee suggested that the rise in drug-resistant TB is because of the inherent weakness of state-run TB control programme and the lack of awareness among patients.

  • Patients do not complete the six-month medication.

  • Also, slashing the five-year budget of RNTC from Rs 6,500 crore to Rs 4,500 crore has only added to the problem of TB control in the country.

  • Scientific evidence also suggests that a delay in the treatment of MDR cases only makes the community more susceptible to the spread of infection.

Way Ahead

  • Preventing resistance against Bedaquiline is a must, but the manner in which it is being done is impractical and undemocratic.

  • If the priority is prevention of drug resistance, then

    • Strict surveillance of MDR cases;

    • Better community outreach programmes to educate the patient & the healthcare provider against treatment dropout;

    • Quality assurance on available anti-TB drugs;

    • Educating physicians against the injudicious use of Anti-TB therapy are far better means of preventing MDR-TB cases.


  • TB is a disease of the poor. A compassionate approach supplemented by scientific rationality is a must in promoting Bed aquiline therapy.

  • The Delhi HC order should be an eye opener to rethink the means of rolling out Bedaquilinetheraphy more effectively and to introduce other drug treatments (like Delaminate) in India.

Hospital-Acquired Infection

In News:

  • WHO report mentioned that over 1.4 million people across the globe suffer from nosocomial or hospital-acquired infection (HAI).

  • It account for over 2 million cases and 80,000 deaths a year.

  • The most common types of HAIs are bloodstream infection, pneumonia, urinary tract infection and surgical site infections.

Hospital-Acquired Infection

  • HAIs are caused mainly due to lack of compliance with infection control guidelines, such as hand hygiene and usage of outdated technology.

  • In India, adherences to structured practicing ways are irregular and hospital accreditation is not mandatory.

  • This situation is further aggravated by the fact that public hospitals receive insufficient funds

  • This results in low nurse-to-patient ratios. This proved to be directly connected to high HAI rates in ICUs.

Way Ahead

  • The first step will be to improve hygiene practices and implement standard operating procedures in all the process of a hospital.

  • Having one nurse for three beds in an ICU is an important risk factor.

  • With limited resources, providing good service is getting severely hampered.

  • The excessive use of antibiotics increases resistance. Therefore, the approach must be to prevent infections and in the process, we can bring down the HAI rate together.


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