Bill & Melinda Gates Foundation, New Delhi, India.
Indian J Med Res. 2012 May;135(5):685-9.
The scale up of DOTS in India is one of the greatest public health accomplishments, and yet undiagnosed and poorly managed TB continues to fuel the epidemic such that India continues to have the highest number of TB cases in the world. Recognizing these challenges, the Government of India has set an ambitious goal of providing universal access to quality diagnosis and treatment for all TB patients in the country. Innovative tools and delivery systems in both the public and private sectors are essential for reaching this goal. Fortunately, India has the potential to solve its TB problem with "home-grown" solutions. Just as Indian pharmaceutical companies revolutionized access to high-quality, affordable AIDS drugs through generic production, Indian diagnostic companies could also become the world's hub for high-quality generic diagnostics. In the long term, India has the potential to lead the world in developing innovative TB diagnostics. For this to happen, Indian industry must move from the import and imitation approach to genuine innovation in both product development as well as delivery. This must be supported by permissive policies and enhanced funding by the Indian government and the private sector. Strict regulation of diagnostics, increased attention to quality assurance in laboratories, and greater engagement of the private health care providers are also needed to effectively deliver innovative products and approaches.
印度的 DOTS 扩展是公共卫生领域最伟大的成就之一，但未确诊和管理不善的结核病仍在继续助长疫情，导致印度的结核病病例数继续位居世界第一。认识到这些挑战，印度政府制定了一个雄心勃勃的目标，即为该国所有结核病患者提供普及的优质诊断和治疗服务。公共和私营部门的创新工具和交付系统对于实现这一目标至关重要。幸运的是，印度有可能通过“本土”解决方案解决其结核病问题。就像印度制药公司通过仿制药生产彻底改变了获得高质量、负担得起的艾滋病药物的途径一样，印度诊断公司也有可能成为高质量仿制药诊断的世界中心。从长远来看，印度有可能引领世界开发创新的结核病诊断方法。要做到这一点，印度工业必须从产品开发和交付的真正创新中，摆脱进口和模仿的方式。这必须得到印度政府和私营部门的宽松政策和增加资金的支持。还需要严格的诊断监管、加强对实验室质量保证的关注以及更广泛地让私营医疗保健提供者参与，以有效提供创新产品和方法。
