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Experts, NGOs oppose WHO proposal on TB

The opinion to reject the proposal was voiced by all the programme officials and NGOs present, arguing that the evidence produced by the WHO officials was weak and the switch from intermittent dose to daily may not prove feasible. feasible.

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The World Health Organisation’s (WHO) South-East Asia regional office (Searo) proposal of  switching on to daily directly observed treatment (DOT ) from intermittent DOT (taken thrice weekly in India) was rejected by the programme officers and TB officials on the second day of the meet on Galvanising evidence for HIV management at the National AIDS Research Institute (NARI) on Friday.

The opinion was voiced by all the programme officials and NGOs present, arguing that the evidence produced by the WHO officials was weak and the switch from intermittent to daily may not prove
feasible.

The officials present including Dr D Behera (Delhi), Dr RR Katti (head for TB and HIV co-infection Maharashtra) and Dr R Sareen (Delhi) refuted the recommendation by Searo and suggested stronger evidence that can support the advice put forward by the WHO tuberculosis official.

Katti, along with other TB officials said, “We cannot change the TB treatment regimen to daily till we have a strong research results supporting it,” he said.

A total of 1.5 million patients suffer from tuberculosis in India. “Annually the success rate of covering these patients is around 87%, which is higher than any other country. This was possible through RNTCP (Revised National Tuberculosis Control Programme) under which we are giving intermittent DOT that has more advantages than the daily DOT. It has better efficacy and less toxicity than the daily DOT,” said Dr VM Ajay Kumar, WHO’s national consultant for RNTCP.

Explaining the advantages he said, “Intermittent DOT is taken thrice a week that makes sure self supervision and reduces daily visit to the DOT centre and the TB officer, who have to observe and watch the patient till he gulps down the pill. Also, the dose is smaller.”

The proposal was presented by Dr Puneet Dewan, medical officer for tuberculosis wqith Searo, who presented a meta-analysis that was put together after collecting various global studies. He told DNA, “We have only recommended. We cannot force the country to change its TB treatment regimen.”

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