Tuberculosis Elimination Strategy

[op-ed snap] Ending TBop-ed snap


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Mains Paper 2: Governance | Issues relating to development & management of Social Sector/Services relating to Health, Education, Human Resources

From UPSC perspective, the following things are important:

Prelims level: UNGA, TRIPS, Doha declaration

Mains level: International and domestic efforts to end TB and challenges therein


Context

UNGA recognition to ending TB

  1. On September 26, the UN General Assembly will, for the first time, address TB in a High-Level Meeting and likely release a Political Declaration, endorsed by all member nations
  2. This is being done to galvanise investment and action to meet the global target of eliminating TB worldwide by 2035

Access to diagnostics and drugs still a problem

  1. Elimination, which means reducing the number to one case per million people per year, will be impossible without universal, equitable access to affordable, quality TB diagnostics and treatment for anyone who needs it
  2. Issues around access to diagnostics and drugs have been considerably diluted in the most recent draft of the Political Declaration
  3. The latest draft is a watered-down version of the original that actively committed to upholding access to affordable generics for all
  4. Various important provisions have been omitted from the draft:
  • A critical omission is that countries may avail of the various flexibilities under the Trade-Related Aspects of Intellectual Property Rights
  • Second, countries may invoke the Doha Declaration to compulsorily license drugs for use in public health emergencies is absent from draft text
  • The option to de-link the pricing of new TB drugs from the costs incurred in their research and development is also not mentioned

TB is curable

  1. TB is, by and large, easily diagnosable and curable
  2. Each day, thousands of people with TB die, often because of inequitable access to quality diagnosis and treatment
  3. India not only accounts for a fifth of the world’s TB burden, it also has the largest number of people living with multidrug-resistant TB

What is needed to end TB?

  1. The rapid emergence of drug-resistant forms of TB (DR-TB) in many countries brings a fresh set of needs including new and comprehensive diagnostic tests and second-line TB drugs, and health systems trained anew to manage DR-TB
  2. India has set a target to eliminate TB by 2025, ahead of the global targets.
  3. These targets cannot be achieved without access to affordable, quality diagnostics/ drugs

Way Forward

  1. India has fought to retain its status as a maker and distributor of generic medicines, thereby protecting the right to health of people in developing countries
  2. Unless India assumes a leadership role to restore every possible option to protect universal access to TB drugs in the Political Declaration, 2018 may end up being just another brick in the wall

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