Stop use of Kanamycin injection: TB activists
TB survivors, activists and organisations have jointly written to the Ministry of Health and Family Welfare demanding the complete phase-out of Kanamycin, an injectable anti-TB drug
Mumbai Tuberculosis survivors, activists and organisations have jointly written to the Ministry of Health and Family Welfare demanding the complete phase-out of Kanamycin, an injectable anti-TB drug, which has many severe side effects including irreversible hearing loss and kidney impairment.
While the Centre has committed to an all-oral treatment regimen for drug-resistant TB patients in several instances, Kanamycin injections still continue to be widely used. The group’s concern was raised by the latest communication from the Centre to all states about utilising unused stocks of 54.19 lakh vials of Kanamycin.
The World Health Organization (WHO) has long removed Kanamycin injection for its treatment guidelines and instead recommends the two new oral anti-TB drugs bedaquiline and delamanid. “The Indian governments Programmatic Management of Drug-Resistant Tuberculosis guidelines issued in 2021 also does not mention the kanamycin injection. Yet, states continue to use it because the other new oral drugs are yet to be made widely available,” said Mumbai based activist Ganesh Acharya, who is one of the signatories to the letter. Some of the signatories include patients who have suffered irreversible hearing impairment due to kanamycin.
The Centre on January 24 issued a circular to the states titled ‘Optimal utilisation of anti-TB drugs’. In the circular, Dr Rajendra Joshi, deputy director-general of the Central TB Division, highlights that there has been less utilisation of some anti TB drugs due to the ongoing Covid-19 pandemic since 2020.
“Despite considering best estimated future consumption of these drugs, stock of some anti TB drugs is unlikely to be used in the TB programme within their shelf life,” Joshi noted circular further listing down the available stocks of eight different anti-TB drugs including 54.19 lakh vials of kanamycin. “The Programme Division is considering a donation of these drugs to medical colleges, hospitals under the state government, central funded hospitals, AllMS, railways and defence hospitals,” Joshi stated.
The course of kanamycin injection goes on for six to nine months and a patient takes as many as 24 injections in a month. “The side effects are so ghastly that patients voluntarily skip these injections at the risk of worsening of their disease,” said Acharya, citing a case of a 28-year-old drug-resistant TB patient in Mumbai who has refused to take the injection after suffering from severe side effects during a previous TB treatment regimen.
“Patients who are put on kanamycin injection are traumatised with the TB treatment,” said Eldred Tellis, director of nonprofit Sankalp Rehabilitation Trust, also a signatory to the letter. “The government simply wants to use the injection because they have it in stock. There is no thought given to the thousands of patients who will suffer from side effects in that attempt,” he said.
The activists demanded that kanamycin be removed from the list of drugs for donation to medical colleges, hospitals under the state government or centre, a clear directive about completely stopping the use of kanamycin at all centres, enhanced access to new oral drugs bedaquiline and delamanid and that kanamycin stocks could be redirected for non-TB use.