Shortage of tuberculosis drugs in Karnataka after Centre stops supply

With the central government stopping the supply of two drugs — cycloserine and linezolid — for treating drug-resistant Tuberculosis (TB) in Karnataka over the past two months, some districts are facing a drug shortage. 

Drug-resistant TB (DR-TB), wherein the bacteria does not respond to common, first-line antibiotics, is more difficult to treat. Currently, Karnataka has around 1,870 DR-TB patients who need second-line drugs like cycloserine and linezolid. Drug shortage is mainly affecting the government’s Directly Observed Therapy (DOTS) and DOTS Plus treatment centres. 

Interruption in treatment could lead to patients relapsing or developing resistance even to second-line drugs. 

While the Central TB Division used to supply all TB drugs to Karnataka earlier, for about a year districts have been procuring certain drugs by themselves after the Centre stopped supply. These were mainly first-line drugs like rifampicin - used to treat drug-sensitive TB. The Centre gave some funds to districts for procurement. 

In addition to cycloserine and linezolid, some districts are now facing a shortage of some first-line drugs, too. The state, currently, has over 50,000 people with drug-sensitive TB who need first-line drugs. 

In BBMP limits, there was a shortage of cycloserine, levofloxacin and pyrazinamide, says a BBMP-level TB official. “Local procurement took time, and some patients’ treatment was affected. The medicines will be available within 3-4 days.” 

The Bengaluru Rural district has stocks of cycloserine and linezolid to last just two weeks, says district TB officer Dr S Nagesh. “These two drugs are very expensive and if we purchase them directly, it will reduce our budget for buying first-line drugs,” he says. 

This year, the highest number of TB patients were recorded within BBMP limits (14,325), followed by Belagavi (4,050), and Kalaburagi and Raichur (3,900 each). 

State Joint Director (TB), Dr Shivayogappa, says they requested the Centre on Friday to give emergency stocks of five drugs - cycloserine, linezolid, rifampicin,  levofloxacin and pyrazinamide.

“We have asked for six months’ stocks, but if that is not available, at least 1-2 months’ stocks. The Centre has said they would supply it in another week,” he says.

“We are also going to ask district TB officers to procure medicines directly through Jan Aushadhi Kendras, with the support of the State Drugs Control Department. Since the purchase would be in small quantities, an elaborate tender process won’t be needed.”