by Amit Chopra
Over the years, the efforts towards elimination of Tuberculosis (TB) have witnessed growing commitment and collaborative actions by different countries. While TB control has evolved significantly, since it was declared a global emergency by the World Health Organization (WHO) in 1993, it remains a major public health concern.
Member States of the WHO and the United Nations are committed to ending the TB epidemic through the adoption of both the End TB Strategy and the Sustainable Development Goals (SDGs). The strategy includes milestones and targets through 2035 for: reduction in TB incidence rates and absolute number of TB deaths, in addition to costs faced by TB patients and their households.
Concerted efforts by the member states led to a cumulative reduction of 11% in the global TB incidence between 2015-2020. However, over the last two years, the impact of the COVID-19 pandemic on access to TB detection and treatment was evident, with a sharp decline in the reporting of people diagnosed with TB. We need to reinvest efforts with increased funding to combat this recent rise in infection rates.
Multi-drug resistance in TB remains a public health crisis
Drug resistance is a challenge towards eliminating TB. The WHO has been working with countries to strengthen drug resistance surveillance, accelerate detection and improve treatment outcomes. Unlike other bacterial pathogens that have evolved to spread drug resistance in populations, drug resistance in Mycobacterium tuberculosis is complex and involves an interplay of clinical, biological and microbiological processes.
Drug susceptibility tests, which test the bacteria for sensitivity to the drugs or to detect resistance patterns, can be molecular or culture-based and have successfully been implemented even in low resource settings.
India’s commitment to TB elimination by 2025
The Government’s National TB Elimination Program outlines strategies under the broad themes of ‘Prevent, Detect, Treat and Build’ to achieve the ambitious target of TB-free India by 2025. The program has progressed tremendously over the past few years, with enhanced engagement with the private sector, and implementation of various forward-looking measures, for notification of TB cases, ensuring sustained availability of TB diagnostic and treatment services, and by leveraging new-age innovations and digital platforms to extend TB services to patients.
Also, a 6.9% increase in the TB budget in 2021 from 2020, reflects a further commitment for building a strong infrastructure for TB detection and treatment.
From detection to susceptibility – offering end-to-end solutions
Particularly in India, drug-resistant TB is a serious concern with the country accounting for 26% of the global cases in 2021. India continues to strengthen its detection efforts with the scaling up of capabilities in molecular diagnostics. Thermo Fisher Scientific remains invested in offering high-impact innovations to address some of the biggest challenges which include early and species-specific diagnosis and detection of drug resistance patterns. The sequencing/ qPCR ecosystem which includes the Applied Biosciences S5 Plus and QuantStudio 5 Dx Real-Time PCR System to simplify workflows.
For culture-based testing, the multi-drug microtiter ‘Sensititre’ plates are an effective tool to provide standardized quantitative minimum inhibitory concentrations (MIC) for drug-susceptibility phenotypes. Timely determination of MICs can help clinicians enable treatment regimen optimization, critical for management of Multi Drug Resistant TB (MDR TB). Liquid Chromatography-Mass Spectrometry systems are playing a pivotal role in clinical research of infectious diseases such as TB. Additionally, a broad portfolio of master mixes and PCR plastics, RNA/DNA for sample preparation and biosafety cabinets, centrifuges, cold storage, pipettes and tips to support the entire end-to-end workflow.
Collaborating for intensified research and innovation
The WHO’s End TB Strategy emphasizes research to optimize implementation and impact while promoting innovations. In India too, the health ministry is focused on developing innovative strategies for facilitating affordable and accessible diagnostics and devising shorter, safer and more effective regimes for MDR TB.Investing in developing new-age technologies and innovative pathways for enhanced patient outcomes. We are working in close collaboration with industry stakeholders, government and academia to advance research in the field of infectious diseases.
Amit Chopra Managing Director, India & South Asia, Thermo Fisher Scientific
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