Timely and accurate diagnosis is the bedrock to stop misuse and overuse of medicines
SHOBHA SHUKLA - CNS
Drug-resistant disease-causing microbes can infect any one of us. Bhakti Chavan, a promising biotechnologist, who never had TB before, got infected with extensively drug-resistant TB (XDR-TB) bacteria. XDR-TB is one of the most serious forms of TB. After some delay, an accurate XDR-TB diagnosis helped her access the right treatment, thanks to an MSF clinic. With steely resolve and grit, she went through the difficult treatment of XDR-TB and got cured. Not only has she defeated XDR-TB, but she also champions the cause of helping those who are fighting TB as well as drug resistance or antimicrobial resistance worldwide.
Bhakti got the WHO recommended molecular test diagnosis. But 79% of people with TB disease in India are not diagnosed on WHO recommended molecular test, but through sputum microscopy which underperforms in diagnosing TB (as per India TB Report 2024). That is why WHO has called upon all the countries to completely replace microscopy with upfront molecular tests for TB diagnosis by 2027. All world leaders re-echoed this call for 100% upfront molecular test diagnosis at the UN General Assembly High Level Meeting on TB last year.
Unless we ensure that timely and accurate diagnosis for TB and all other diseases is a reality on the ground, how will we stop misuse or overuse of medicines and prevent antimicrobial resistance?
People-centred diagnostics, treatment and care is key
Even though they face the brunt of it, most people have very little understanding and awareness about antimicrobial resistance (AMR). Bhakti Chavan blames it on the lack of people-centred responses to address AMR.
Bhakti, who has done her post graduation in Biotechnology and currently works with a biotech company, says that, "Many countries have National Action Plans to address AMR, but the ground level realities are very different. Take for example TB. Despite India having a National Strategic Plan to end TB (2017-2025), there are many gaps in TB care- like shortage of medicines, restricted access to novel medicines, diagnostic delays due to non-accessibility of molecular tests. All these act as roadblocks for the underprivileged in accessing the best of diagnostics and treatment. Our public health programmes must ensure that the best possible care is available to all those in need, and also ensure prevention of spread of infection. So patient-centred diagnostics (including upfront drug sensitivity testing), treatment and care is most important to combat AMR."
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