Johnson & Johnson expands efforts to help end tuberculosis in India

Johnson & Johnson has announced the expansion of its tuberculosis (TB) programme in India. Through a series of new collaborations with several multilateral and non-governmental organisations (NGOs), as well as the Government of India, the company aims to help support the country’s efforts to end TB by 2025, as outlined in its National Strategic Plan for TB Elimination. A major part of Johnson & Johnson’s comprehensive 10-year initiative to achieve a world without TB, this expanded India programme aims to broaden appropriate access to treatment for multidrug-resistant TB (MDR-TB), improve detection of undiagnosed cases, build critical health systems capacity and raise awareness about TB at the community level. Earlier this month, Johnson & Johnson committed to invest $500 million over the next four years to help end the TB and HIV epidemics.

“TB is a devastating disease that needlessly claims nearly half-a-million lives in India every year,” said Sarthak Ranade, Managing Director, Janssen India, Johnson & Johnson. He added, “Fortunately, we have better tools today than ever before, which offer new hope to patients, families and communities affected by TB. What is needed now – and urgently – is coordinated action. This is why we are proud to collaborate with our partners to comprehensively address the challenges presented by TB and DR-TB.”

TB is the world’s deadliest infectious disease and one of the leading causes of mortality associated with antimicrobial resistance (AMR). India bears the highest burden, accounting for more than a quarter of all new TB cases worldwide. Growing resistance to the most commonly used drugs compounds this public health challenge, with an estimated 130,000 new cases of DR-TB reported in India in 2018. Improvements in diagnosis and treatment rates are needed to help control the TB epidemic: in 2018, an estimated one in three people with TB were not identified or diagnosed, and one in four were not connected to treatment.

The programme includes the following:

Improving diagnosis rates and linkage to care

• A new effort with The Foundation for Innovative New Diagnostics (FIND), in collaboration with India’s Revised National Tuberculosis Control Programme (RNTCP), will provide technical assistance to build capacity and establish new TB culture and drug-susceptibility testing facilities in at least seven sites across India – with a focus on the high-burden TB states of Maharashtra, Himanchal Pradesh and Tamil Nadu. This will help accelerate efforts to reach the WHO-recommended number of facilities in the country.

• Expanded funding for state governments and NGOs to enhance rates of early TB diagnosis. To date, J&J funding has enabled the provision of nearly 50,000 X-ray tests, approximately 32,000 molecular tests, and 4,600 pre-evaluation tests free-of-charge. Approximately 8,000 new TB

cases and 1,000 DR-TB cases have been detected to date.

• Pilot initiative with TB Alert India to expand TB-control efforts in the private sector, where most patients initially seek care. This pilot project aims to strengthen the referral of patients from the private to public health system for appropriate and timely diagnosis and treatment. The model involves deployment of field staff, a dedicated call centre and an online treatment adherence platform, Connect for LifeTM, developed by Johnson & Johnson to help track and support patients throughout their treatment.

Training healthcare workers to improve standards of care

• A unique collaboration with the International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia office, to support efforts aimed at building capacity of public sector healthcare providers for the effective management of TB and DR-TB. Through this project, Johnson & Johnson will support capacity building workshops and trainings and the development of training materials to improve the understanding of India’s guidelines on programmatic management of DR-TB among clinicians and healthcare workers in seven high-burden states.

• Ongoing efforts to elevate the standard of care for DR-TB management in the country, which, to date, have supported the training of more than 15,000 healthcare professionals across ten high-burden states, with plans to train an additional 5,000 healthcare professionals by 2020.

Raising awareness of signs and symptoms of tuberculosis

• Launch of a mass awareness and behaviour-change campaign “MTV Nishedh,” in partnership with the MTV Staying Alive Foundation. Launched in September 2019, the campaign aims to place a spotlight on TB as an urgent public health issue, while at the same time, helping to reduce the social stigma associated with the disease in order to prevent TB transmission and encourage patients to seek treatment.

• Launch of a metro awareness project in Hyderabad in collaboration with local government and TB Alert India, that aims to increase awareness of TB through visual campaigns in 45 metro trains.

• In addition to this, Johnson & Johnson has supported community awareness campaigns that involved 24,000 auto-rickshaws, 21,000 buses, 200 taxis, 11 trains, seven radio stations, 112 theatre screens and 590 street plays.

“Johnson & Johnson’s experience in introducing a new TB medicine shows that medicines alone are not enough to tackle AMR,” says Dr Vandita Gupta, Franchise Head, Infectious Diseases, Janssen India, Johnson & Johnson. “We must strengthen our public health systems, train more health workers on the appropriate management of TB and DR-TB, raise community awareness, and ensure patients are diagnosed in a timely way and then successfully treated.

For the past four years, Johnson & Johnson has worked with the government of India to help scale up access to bedaquiline, including by providing 22,000 courses free-of-charge as part of a donation programme, coordinated in partnership with the United States Agency for International Development (USAID).