Bedaquiline

Subject : Science and technology

Section: Health

Concept :

Drug resistant tuberculosis (DRTB) has posed a significant public health challenge for decades.
After 50 years, a new drug to treat TB — bedaquiline —was approved. It had been developed with significant public funding, including from the United States National Institute of Allergy and Infectious Diseases.
Bedaquiline is now core to WHO recommended treatment regimens,thanks to the collective work of the TB community and treatment providers. Despite the joint effort, it is Johnson & Johnson (J&J) that holds a monopoly on the drug in many countries.
A formulation patent would not prevent generic manufacturers from developing the active pharmaceutical ingredient in their own formulations after July 2023.

Bedaquiline

Bedaquiline is a medication used to treat active tuberculosis.
Specifically, it is used to treat multi-drug-resistant tuberculosis (MDR-TB) along with other medications for tuberculosis.
It is a oral drug.

Tuberculosis

It is an infectious disease caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. TB is spread from person to person through the air.
About one-third of the world’s population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with disease and cannot transmit the disease.

Drug-resistant forms of TB

Misuse or inappropriate use, as well as poor quality of antibiotics have resulted into drug-resistant forms of TB. These drug-resistant forms range from multi-drug resistant TB (MDR-TB) up to extensively drug-resistant TB (XDR-TB):
Multi-drug resistant TB: It is resistant to at least Isoniazid and Rifampicin, two of the most effective TB drugs. It can only be treated with expensive, newer antibiotics over a longer period.
Extensively drug-resistant TB: It is resistant to almost all forms of medical treatment with little hope of survival for the victims.

Is Tuberculosis Curable?

Tuberculosis is curable and preventable but it is a complex disease. On the one hand, it can affect different areas of the human body, such as the lungs, the lymph nodes, the skeletal system or the brain.
On the other hand, different types of TB exist, which can either be completely curable, but in the case of drug-resistant forms could also mean certain death.

TB Burden in India

As per the Global TB Report 2017, India accounts for about a quarter of the world’s TB cases (approx.28, 00,000 occurred and 4.5 lakh people died due to TB) and also shares the highest burden of both TB and MDR TB.
There are an estimated 79,000 multi-drug resistant TB patients among the notified cases of pulmonary TB each year.
India is also the country with the second highest number (after South Africa) of estimated HIV associated TB cases.
India also has more than a million “missing” cases every year that are not notified and most remain either undiagnosed or unaccountably and inadequately diagnosed and treated in the private sector.

The National Strategic Plan (2017-2025):

It is crafted in line with other health sector strategies and global efforts, such as the draft National Health Policy 2015, WHO’s End TB Strategy and the Sustainable Development Goals.
It is aiming to achieve elimination of TB, by 2025. During plan period, targets for TB are:
80% reduction in TB incidence (i.e. reduction from 211 per lakh to 43 per lakh)
90% reduction in TB mortality (i.e. reduction from 32 per lakh to 3 per lakh)
0% patient having catastrophic expenditure due to TB
TB elimination have been integrated into the four strategic pillars of “Detect – Treat – Prevent – Build” (DTPB).
It has also linked Bank Account, AADHAR and NIKSHAY for direct cash benefits to patients.