Tuberculosis remains a significant public health concern in India, with over 5,000 new cases reported daily and nearly 1,000 fatalities. India carries the highest burden of TB globally, with approximately 1.9 million cases annually. The highly contagious nature of the disease underscores the urgent need for effective prevention and treatment measures. Left untreated, a single sputum-positive individual can infect 10-15 others in a year, highlighting the importance of prompt intervention.
The emergence of drug-resistant TB strains poses a formidable challenge to the medical community, attributed to the unregulated availability and inappropriate use of anti-TB medications. The lack of standardized treatment regimens and treatment adherence has led to the prevalence of multidrug-resistant TB (MDR-TB). In response, India has launched the DOTS Plus Program to combat MDR-TB, aiming to integrate it with the existing Directly Observed Treatment, Short-Course (DOTS) program.
The DOTS Plus Program, initiated in 2003 under the auspices of Lilly, operates as a multifaceted initiative involving collaboration among public and private healthcare professionals, international organizations, academia, and pharmaceutical companies in developing regions. Known as the Lilly MDR-TB Partnership, the program encompasses various activities:
1. Community Support and Patient Advocacy: The partnership supports nonprofit organizations in implementing community-based programs to raise awareness and provide support for TB treatment. Initiatives such as photo essays highlight the challenges faced by TB patients and caregivers, while community events like the Lilly Global Day of Service engage volunteers in activities aimed at promoting TB awareness.
2. Training: Collaborating with India’s largest healthcare professional association, the Indian Medical Association, the program provides training for private healthcare practitioners on TB treatment protocols aligned with national guidelines. Additionally, training programs for nurses emphasize infection prevention and environmental hygiene.
3. Technology Transfer: Lilly facilitates the transfer of manufacturing technology for second-line TB drugs to domestic companies in India, Russia, South Africa, and China. This initiative includes grants for equipment procurement and facility upgrades, along with business management training in partnership with Purdue University and instruction in Good Manufacturing Practices.
4. Media Sensitization: Leveraging media platforms worldwide, the program disseminates accurate information about TB and MDR-TB. Collaborative efforts with NGOs and other organizations aim to raise awareness through media campaigns focused on educating both patients and the general public.
Through these comprehensive efforts, the DOTS Plus Program endeavors to address the challenges posed by MDR-TB and strengthen TB control measures in India and beyond.