‘TB med shortage will have real-world repercussions’

If patients miss out on medicines, the city could experience a resistance pattern to these medications, say doctors. File pic

Civic officials claim that the shortage of essential drug-resistant tuberculosis (DR-TB) medicines has come to an end, but some DOTS centres have a different story to tell. DOTS personnel claim they were provided inadequate funds to procure the drugs. In the scenario, doctors have warned that if patients have been missing out on doses for two to three months, the city could experience a resistance pattern to the medications.

This could lead to an increase in drug-resistant tuberculosis cases. "The issue still persists. Funds were allocated to district TB officials to procure medicines at the local level due to the shortage, but they were insufficient to meet the needs of the DOTS centres in their jurisdiction," said one DOTS centre official in M East ward.

Stock exhausted

DOTS officials have reported that they have exhausted their stock of linezolid and cycloserine. Varsha Puri, the City TB Officer, denied that DOTS were provided inadequate funds, adding, "We are yet to restock cycloserine. It has just arrived from Gujarat. We have already supplied linezolid and allowed district TB officials to purchase clofazimine."

She added that 65,000 tablets of linezolid have already been supplied, and another lakh are expected by Friday. "Cycloserine will be restocked tomorrow. Clofazimine costs R3 to R6 per tablet, and we have provided Rs 5,000, allowing them to purchase it at the local level." Notably, private medical shops are also experiencing a shortage of clofazimine and cycloserine.

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Dr Vikas Oswal, a Mumbai-based pulmonologist and member of the national technical expert group under Central TB division, said, "If there was no adequate local procurement even after the states were asked to do so, then it was the failure of the system. There shouldn't have been any problem in procuring linezolid locally because it was never short at private medical shops."

Earlier, another health department official told mid-day that the Central TB Division under the Ministry of Health alerted the states about the shortage at the very last moment. The official had said that if the CTD had told the states to procure supply at an earlier stage, shortages would not have happened.

Doctor warns

Dr Oswal added that there are alternative medicines in place in case of shortage of any one medicine. "There have been logistical difficulties from CTD but it has not happened that all three medicines were short at once at any particular DOTS centre," Dr Oswal said. However, mid-day has earlier reported instances where more than one medicine has been short at these centres.

There are 19,311 cases of TB at public health centres. Asked about the impact if patients have been missing out on doses for two to three months, Dr Oswal added that the city is likely to experience a resistance pattern to these medications. "If that is the case at large then it is going to be a bad scenario in the field. There is no doubt in that. If resistance in patients increases, we will see more DR-TB cases," he said.