Tuberculosis Elimination Strategy

[op-ed snap] Incentivizing new vaccine development

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Mains Paper 3: Science & Technology | Science and Technology- developments and their applications and effects in everyday life Achievements of Indians in science & technology; indigenization of technology and developing new technology

From UPSC perspective, the following things are important:

Prelims level: Particulars of the TB disease, Click2read

Mains level: Issues discussed in the article, regarding the development of an effective vaccine


Tuberculosis (TB) is one of India’s severest health crises

  1. It kills two Indians every 3 minutes and more than 1,000 people every day
  2. India accounts for 27% of the world’s 10.4 million new TB cases, and 29% of the 1.8 million TB deaths globally
  3. Surely, this says something about the crisis in our public health policy
  4. And receltly, WHO’s deputy governor was saying that India doesn’t have a good TB vaccine

Issues with the current vaccine

  1. TB is difficult to diagnose, and the BCG vaccine that is currently in use (developed in the early 20th century) is ineffective for young people and adults
  2. A new vaccine, cheaper and effective diagnostic tests, and treatment for the drug-resistant strains of TB are needed

Why should government focus on vaccine development?(for TB)

  1. The government should have focused more on creating a vaccine
  2. They are easy to administer, need little diagnosis before use and can be taken in a few doses rather than involving long treatments

Lack of progress in developing a vaccine for TB

  1. It is part of a larger problem
  2. There is a dearth of overall R&D on diseases concentrated in poor countries

Reasons behind the lack of private investment in the area(in countries like India)

  1. One reason for the lack of private investment is that the potential consumers (patients and governments) are poor
  2. But there are two other reasons:
  3. The benefits of the research on these diseases spill over to many countries, so none of the small countries has an incentive to unilaterally support the research
  4. Governments have a poor record of respecting patents
  5. WHO’s The Agreement on TRIPS has provisions for ‘compulsory licensing’ that allow governments to license the production of essential drugs to local manufacturers who must then pay royalties to the innovator
  6. The problem, therefore, is that the medical innovation industry doesn’t consider poor countries as their market

Government’s goal of eradicating TB

  1. Government has announced the goal to eliminate TB by 2025
    National Strategic Plan (NSP) for TB Elimination
  2. The main features of the proposed National Strategic Plan (NSP) for TB Elimination, 2017-2025 are providing (i) incentives to private hospitals to follow standard protocols for diagnosis and treatment,
    (ii) giving cash transfers to patients to compensate them for the direct and indirect costs of undergoing treatment as well as incentives to complete treatment
  3. This is in addition to free diagnostics and treatment for TB at government hospitals
  4. Given the fact that incomplete treatment and improper care leads to the development of drug-resistant TB, these interventions are welcome

The way forward

  1. The government must take steps to encourage research, both basic and applied
  2. It could make budgetary accommodation, or use its position in global diplomacy to encourage other nations and donors to do so
  3. Ultimately, it will have to appeal to the interest of private companies for medical innovations
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