There have been some media reports alleging shortage of anti-TB drugs in India and questioning the effectiveness of such drugs under the National TB Elimination Programme (NTEP).  Such reports are vague and ill-informed, without any specific information on the availability of anti-TB medicines in stock.

The treatment of drug sensitive tuberculosis consists of two months of four drugs available as 4 FDC (Isoniazid, Rifampicin, Ethambutol and Pyrazinamide) followed by two months of three drugs available as 3 FDC (Isoniazid, Rifampicin and Ethambutol). All these drugs are available with sufficient stocks ranging six months and above.

The treatment regimen of Multi Drug resistant TB consists of usually four months of 7 drugs (bedaquiline, levofloxacin, clofazimine, isoniazid, ethambutol, pyrazinamide and ethionamide) followed by five months of 4 drugs (levofloxacin, clofazimine, pyrazinamide and ethambutol). In about 30% of persons with drug resistant TB, cycloserine and linezolid is required.

Procurement, storage, maintenance of stock and in-time distribution of anti-TB drugs & other materials are being done at the Central level under NTEP. In rare situations, States were requested to procure few drugs locally for a limited period by utilizing the budget under National Health Mission (NHM) so that individual patient care is not affected. Maharashtra has already procured Cycloserine Tablets centrally. Few States have delegated procurement to districts; accordingly, districts have procured wherever there is requirement.

The status of the stock position of the anti TB drugs in the State of Maharashtra, which is highlighted in the concerned media reports is as below (Source: Ni-kshay Aushadhi)

There is no shortage of Anti-TB drugs in the field. The current stock of these drugs at National Level as on today (26 Sept 2023) as per Ni-Kshay Aushadhi is as follows:

As such, more than 15 months stocks of Moxifloxacin 400mg and Pyridoxine are available under NTEP. Also, Delamanid 50 mg and Clofazimine 100 mg were procured in August 2023 and supplied to all states and UTs. Moreover, P.O has been issued on 23.09.2023 for the supply of additional 8 lakh qty of Delamanid 50 mg tablets.

In addition to the stocks mentioned above, the purchase orders were issued for the supply of Linezolid-600mg & Cap Cycloserine-250 mg in August 2023.  The drugs are being dispatched to the states.

Significant efforts have been made to ensure the availability of these essential anti TB drugs. Regular assessments are conducted to evaluate the stock positions at various levels, from central warehouses to peripheral health institutes.

Hence, the information mentioned in the media reports are vague and ill-informed and do not reflect the correct picture of the available stock of anti-TB drugs in the country.

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MV

HFW/MythsVsFacts-Shortage of TB Meds/26^th Sept/2023/1