Fusing journalism and TB – telling the stories as they are

One V and two Ds

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TB is completely curable. TB can be eradicated. India has one of the world’s most successful TB control programmes.

And yet, it is a known fact that India continues to have the highest burden of TB in the world and accounts for around on fifth of the global incidence. Out of 9.4 million new TB cases globally, 2 million are estimated to have occured in India. Around 280,000 people succumbed to TB in 2009. Why? Why are we not able to bring the situation under control, like we have say with Polio or Diptheria?

Control of TB is governed by one V and two Ds – Vaccines, Diagnosis and Drugs. And as experts say, all three are outdated. The BCG Vaccine recently celebrated its 90th anniversary; the smear microscopy test, which is still the most widely used diagnostic tool is 125 years old and the most used TB drug is over 40 years old. Additionally, serological (antibody tests) are highly innacurate, and they are still being widely misused by the private sector for diagnosis of TB. These tests are not recommended by the RNTCP or any agency. On the contrary, the WHO has issuesd alerts against the use of serological tests.

Advances in all three areas are vital but given that we already have a huge problem on hand, diagnosis and drugs have an urgent and important role to play in the control of TB. And yet, industry does not seem to be responding to the problem with the urgency that it needs to.

It was to showcase the dire need for newer and more efficient diagnostics and encourage industry to look at diagnostics as a viable business opportunity that a conference entitled “TB diagnostics in India – From importation and imitation to innovation” was held on 25 & 26 August at the St John’s Research Institute. The conference attracted an international audience that consisted of RNTCP representatives, academicians, scientists, researchers, funding agencies and members of the pharmaceutical industry.

The sessions were structured in a manner that gave opportunities for the problem to be examined through several lenses, the most important one being that of why industry should consider the R&D of diagnostics as lucrative. Numbers were projected, a business case was presented which sought to project that it made good buiness sense to develop and manufacture good diagnostic tools for TB.

The organisers must be lauded for the effort and the conference itself was an indicator of the commitment they displayed towards the control of TB. In what can be seen as a first, industry was included as a stakeholder in the dialogue itself. The scale and problem of TB was presented to them and what was also something of a first was that the government representatives present, admitted that diagnosis suffered owing to lack of robust diagnostic tools.

Some questions however remain in the minds of external stakeholders like me. What is more important? Numbers or lives? Understandably, industry must be aware of numbers, bottomlines, profitability, feasibility and any other words that fit into that category, as also to the fact that they have to answer their shareholders. But what about the people who suffer from undiagnosed or misdiagnosed TB? When these very priorities of industry prevent doctors from saving precious lives, who is answerable? There are giant pharma industries in the world that have made indeterminate amounts of money, developing and rolling out drugs for hypertension, diabetes, cancer and even TB. Can these companies not subsidise TB diagnostics? Can they not set aside minuscule amounts of their profits for the R&D of TB diagnostics? Or is that the altruistic view of a hopeless idealist?

The conference was hosted by St John’s Research Institute and McGill University, with technical assistance from Bill and Melinda Gates Foundation, Foundation for Innovative New Diagnostics, Stop TB Partnership and others.

Bharathi Ghanashyam

Written by JournalistsAgainstTB

August 26, 2011 at 4:08 pm

Posted in TB and Media

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