The Ministry of Health and Family Welfare (MoHFW) has stated that media reports that claim a shortage of anti-TB (Tuberculosis) and question the effectiveness of such drugs are "vague" and "ill-informed". The notice issued by the ministry added that these drugs, which come under the National TB Elimination Programme (NTEP), go under regular assessments to evaluate the stock positions at various levels, from central warehouses to peripheral health institutes.
National stock of anti-TB drugs
On a national level, the stock of anti-TB drugs stock status of these anti-TB drugs as of today, September 26, based on data from Ni-Kshay Aushadhi, is as follows:
-Cycloserine -250 mg: 1,479,857 units
-Linezolid – 600 mg: 995,779 units
-Delamanid - 50 mg: 1,137,802 units
-Levofloxacin – 250 mg: 2,885,176 units
-Levofloxacin – 500 mg: 3,327,130 units
-Clofazimine - 100 mg: 1,286,360 units
-Moxifloxacin - 400 mg: 27,249,866 units
-Pyridoxine: 27,299,242 units
As per the above data, more than 15 months of stocks of Moxifloxacin 400mg and Pyridoxine are available under NTEP.
The health ministry added that Delamanid 50 mg and Clofazimine 100 mg were procured in August 2023 and supplied to all states and UTs. Purchase orders for Linezolid-600mg and Cap Cycloserine-250 mg were also issued in August and are being dispatched to states. Moreover, an additional supply of 800,000 quantities of Delamanid 50 mg tablets are expected by September 29.
Drug-sensitive TB treatment
Explaining the relevance of the drugs mentioned above, the ministry informed that for the treatment of drug-sensitive tuberculosis consists of two months of four drugs available as four fixed-dose combinations (FDC) of Isoniazid, Rifampicin, Ethambutol, and Pyrazinamide.
This is followed by two months of three FDC, which include Isoniazid, Rifampicin, and Ethambutol. The health ministry assures that all these are available in sufficient stock.
Multi-drug resistant TB (MDR-TB) treatment
Regarding multi-drug resistant TB (MDR-TB) treatment, four months of seven drugs occurs. This includes bedaquiline, levofloxacin, clofazimine, isoniazid, ethambutol, pyrazinamide, and ethionamide. This is followed by five months of four drugs, which may include levofloxacin, clofazimine, pyrazinamide, and ethambutol.
In approximately 30 per cent of individuals with drug-resistant TB, cycloserine and linezolid may also be required.
Procurement and distribution
The procurement, storage, maintenance of stock, and distribution of anti-TB drugs and other materials are managed under the NTEP at a central level. In some rare situations, states are requested to procure specific drugs locally for a limited period using the budget allocated under the National Health Mission (NHM) to ensure that individual patient care is not compromised. For example, Maharashtra has already centrally procured Cycloserine Tablets, and some states have delegated procurement to districts as per their requirements.