An outline of India's PMDT (Programmatic Management of Drug Resistance Tuberculosis)

India accounts for nearly one-fourth of the annual incidence of tuberculosis cases worldwide, making it a significant public health concern. In India, 2.8 million individuals are expected to contract TB annually, and 4.8 lakh are thought to pass away from it. With measurable goals of a 50% and 75% decrease in incidence and related mortality, respectively, by 2025 and equivalent reductions of 90% and 95% by 2035, India has officially entered the National Strategic Plan and is a signatory to "The End TB Strategy."

There is still a long way to go, despite a comprehensive national TB control program that serves as a roadmap for states to implement TB diagnosis and treatment. Although there has been a modest drop in TB incidence, mortality rates are still alarmingly high, and the advent of drug-resistant TB has grown to be a serious problem. Person-to-person transmission and improper administration of TB treatment are to blame for the ongoing emergence and spread of drug resistance. A rigorously adhered-to, 6-month treatment regimen given to patients with support and supervision can cure the majority of TB patients.

Drug resistance can develop and spread, especially in crowded environments like ours, as a result of improper or inappropriate antimicrobial drug use, the use of ineffective drug formulations (such as the use of single drugs, insufficient dosages, low-quality medications, or poor storage conditions), and premature treatment interruption.

The two most effective anti-TB medications for resistant strains are rifampicin (R) and isoniazid (H) (multidrug-resistant tuberculosis, MDR-TB). Patients with MDR-TB respond poorly to treatment and typically have significant fatality rates. These patients demand a sizable share of healthcare resources since they need to be treated with pricy, toxic second-line medications and may need to be hospitalized to manage their toxic responses and other consequences.

Programmatic Management of Drug-resistant Tuberculosis (PMDT): Previously known as DOTS-Plus, PMDT is offered as a specific service under the DOTS package's enlarged framework for managing MDR-TB. With the hope that good DOTS implementation will lower the occurrence of drug-resistant TB patients, DOTS implementation should be given a greater priority over PMDT deployment. India started providing MDR-TB diagnostic and treatment services in 2007 and attained full coverage in 2013. As of 2016, 1,39,369 people had been diagnosed with MDR-TB or RR TB.

Controlling TB faces numerous difficulties in India. As the cornerstone of any effort to reduce tuberculosis, prompt, accurate diagnosis and successful treatment of TB are as important for patient care as they are for the public health response to the disease. In India, the private sector actually dominates the provision of healthcare services. The program has extremely limited access to data on TB patients from the private sector, and nothing is known about the quality of their care, including treatment outcomes. The goal of India's national TB control program is to ensure that those who are ill with TB receive the best possible assistance and care from the medical professionals of their choice.