Excerpt

Presentations at the workshop addressed the following topics: TB (tuberculosis) and MDR (multi-drug resistant) TB in India, including local and national responses to the epidemic (Chapter 2); the global burden of TB and drug-resistant TB, including data from another high-burden country, China (Chapter 3); prevention of the transmission of drug-resistant TB in India (Chapter 4); rapid methods of detecting drug resistance and strengthening laboratory capacity (Chapter 5); approaches to reaching vulnerable populations affected by drug-resistant TB (Chapter 6); public–private engagement and innovative methods in combating drug-resistant TB (Chapter 7); the drug supply chain for second-line drugs (Chapter 8); and the major viewpoints expressed at the workshop and next steps suggested by workshop participants (Chapter 9).

Contents

• THE NATIONAL ACADEMIES
• PLANNING COMMITTEE ON FACING THE REALITY OF DRUG-RESISTANT TUBERCULOSIS IN INDIA: CHALLENGES AND POTENTIAL SOLUTIONS
• FORUM ON DRUG DISCOVERY, DEVELOPMENT, AND TRANSLATION
• Reviewers
• Acronyms
• 1. Introduction
  • HISTORY AND DIMENSIONS OF THE PROBLEM
  • THE BURDEN OF DRUG-RESISTANT TB
  • TREATING TB IN CONTEXT
  • OVERVIEW OF TB AND MDR TB IN INDIA
  • SETTING THE STAGE
  • ORGANIZATION OF THE REPORT
• 2. Drug-Resistant TB in India
  • THE BURDEN OF TB AND MDR TB IN INDIA
  • PLANS OF THE REVISED NATIONAL TB CONTROL PROGRAM
  • INVOLVEMENT OF THE PRIVATE SECTOR
  • CHALLENGES TO THE REVISED NATIONAL TB CONTROL PROGRAM
  • TREATMENT OF DRUG-RESISTANT TB
  • IMPROVING HEALTH SYSTEM PERFORMANCE TO ADDRESS THE CHALLENGE OF DRUG-RESISTANT TB
  • POTENTIAL INNOVATIONS AND ACTION ITEMS
• 3. The Global Burden of Drug-Resistant TB
  • OVERVIEW OF THE GLOBAL BURDEN OF TB AND MDR TB
  • MDR TB PREVENTION AND CONTROL IN CHINA
  • HISTORICAL PERSPECTIVE ON TB AND MDR TB CONTROL EFFORTS
  • GLOBAL CHALLENGES AND POTENTIAL SOLUTIONS
  • POTENTIAL INNOVATIONS AND ACTION ITEMS
• 4. Preventing Transmission of Drug-Resistant TB
  • INDIA'S PROGRAM EFFORTS TO PREVENT TRANSMISSION OF DRUG-RESISTANT TB
  • THE IMPACT OF TREATMENT ON MDR TB TRANSMISSION
  • THE GENETIC EVOLUTION OF M.tb.
  • THE MOLECULAR EPIDEMIOLOGY OF M.tb.
  • POTENTIAL INNOVATIONS AND ACTION ITEMS
• 5. Detecting Drug Resistance and Strengthening Laboratory Capacity
  • DIAGNOSIS OF DRUG-RESISTANT TB
  • QUALITY ASSURANCE CONSIDERATIONS IN THE DEVELOPMENT OF NEW DIAGNOSTICS
  • THE SUPRANATIONAL REFERENCE LABORATORY NETWORK
  • EXPANDING LABORATORY CAPACITY IN INDIA FOR THE DIAGNOSIS OF DRUG-RESISTANT TB
  • POTENTIAL INNOVATIONS AND ACTION ITEMS
• 6. Addressing TB and Drug-Resistant TB in Vulnerable Populations
  • DRUG-RESISTANT TB IN PEDIATRIC POPULATIONS
  • THE BURDEN OF PEDIATRIC TB IN HOUSEHOLDS OF PATIENTS WITH MDR TB
  • DRUG RESISTANCE IN HIV-INFECTED POPULATIONS
  • DRUG-RESISTANT TB IN MIGRANT AND REFUGEE POPULATIONS
  • CASE STUDIES IN CAMBODIA AND ETHIOPIA
  • POTENTIAL INNOVATIONS AND ACTION ITEMS
• 7. Combating Drug-Resistant TB Through Public–Private Collaboration and Innovative Approaches
  • OPERATION ASHA: “GOING THE LAST MILE”
  • ENGAGING THE PRIVATE SECTOR IN INDIA
  • TECHNOLOGICAL INNOVATIONS IN TB CONTROL
  • POTENTIAL INNOVATIONS AND ACTION ITEMS
• 8. Confronting Challenges to the Supply Chain for Second-Line Drugs
  • CHALLENGES IN DRUG SUPPLY CHAIN LOGISTICS
  • INDIA'S SECOND-LINE DRUG SUPPLY CHAIN
  • IMPROVING THE AVAILABILITY AND REDUCING THE COST OF MDR TB DRUGS
  • MOVING TOWARD A FUNCTIONAL MARKET FOR SECOND-LINE TB DRUGS
  • DISCUSSION
  • POTENTIAL INNOVATIONS AND ACTION ITEMS
• 9. Creating a Blueprint for Action
  • DRUG-RESISTANT TB IN INDIA
  • PREVENTING TRANSMISSION OF DRUG-RESISTANT TB
  • STRENGTHENING LABORATORY CAPACITY
  • ADDRESSING TB AND DRUG-RESISTANT TB IN VULNERABLE POPULATIONS
  • COMBATING DRUG-RESISTANT TB THROUGH PUBLIC–PRIVATE COLLABORATION AND INNOVATIVE APPROACHES
  • STRENGTHENING THE SECOND-LINE DRUG SUPPLY CHAIN
• References
• APPENDIXES
  • Appendix A. Workshop Agenda
  • Appendix B. Summary of a Joint Meeting of the National Institute of Allergy and Infectious Diseases, National Institutes of Health, and Indian Biomedical Research Agencies, Held April 20-21, 2011, New Delhi, India
  • Appendix C. Participant Biographies

Rapporteurs: Steve Olson, Rebecca A. English, Rita S. Guenther, Anne B. Claiborne

Suggested citation:

IOM (Institute of Medicine). 2012. Facing the Reality of Drug-Resistant Tuberculosis in India: Challenges and Potential Solutions: Summary of a Joint Workshop. Washington, DC: The National Academies Press.

The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the project.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.