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The Hindu
14-07-2025
- Health
- The Hindu
The paradox of market restriction for anti-TB drugs
Tuberculosis (TB) could be drug sensitive (DS TB), which can be treated by a few first-line oral drugs, or drug resistant (DR TB), wherein there is resistance to one or more drugs, making it difficult to treat, potentially leading to more complications and even death. Drugs for any form of TB are provided free of cost through the Indian government's National Tuberculosis Elimination Programme (NTEP). Newer anti-tubercular (anti-TB) drugs like Bedaquiline, Delamanid and Pretomanid are key drugs that have revolutionised the treatment of DR TB, since they are orally administered and require shorter treatment durations compared to the older regimen of daily injections, which were to be taken for many months. Another key drug is Rifapentine, which is mainly used to prevent TB in people who have come in contact with TB-infected individuals or in people with HIV disease. The Drugs Controller General of India (DCGI), following a letter from the Central TB Division of the Ministry of Health & Family Welfare, mooted an important proposition regarding the regulation of newer anti-TB drugs in the private market, in the 66th Drugs Consultative Committee (DCC) meeting held on June 17, 2025. The DCGI is planning to restrict access to the newer anti-TB drugs Bedaquiline, Delamanid, and Pretomanid and Rifapentine by making them conditionally accessible only through NTEP, in adherence to the Standards of TB Care in India. The reasons and implications of this move need to be closely examined. The mechanism of supplying drugs under NTEP NTEP has its own exclusive procurement and supply chain management system for anti-TB drugs, laboratory consumables and TB preventive drugs. India, like many countries in the world, procures most of its anti-TB drugs from the Global Drug Facility (GDF ) , a not-for-profit establishment funded by the Global Fund, along with procurement via domestic funding through the Central Medical Services Society . GDF does not aim to make a profit and therefore provides drugs and consumables at very low prices to countries through bulk procurement. The Central TB Division places an order to GDF at least one year prior by forecasting the need, based on the disease burden in the country. The drugs are then routed through Government Medical Store Depots to State Drug Stores of NTEP, from where they go to District Drug Stores and then down to DOTS centres at Tuberculosis Units and Peripheral Health Institutions. This entire process is managed real-time through a portal called Ni-Kshay Aushadh i , which is accessible only to NTEP personnel. The Central procurement of drugs is based on drug requests received from peripheral health institutions at the grassroots level. Timely online drug requests through the Ni-Kshay Aushadhi portal are imperative for uninterrupted procurement and supply of drugs in NTEP. However, studies have shown the sub-optimal use of the portal in the field owing to various reasons like lack of digital literacy and training of peripheral level staff, portal interface not being user-friendly and stock planning and forecasting not being perceived as a 'felt need' by staff. Why restrict access to newer anti-TB drugs A new drug that is developed can be patented by the company that developed it (originators) for a minimum of 20 years. No other company can undertake commercial production of the drug during this period. However, when a drug goes off-patent (expiry of patent period), it can be manufactured by any other pharmaceutical company and can be marketed for use. Patenting was done in the case of Bedaquiline (Johnson & Johnson), Delamanid (Otsuka), Pretomanid (TB Alliance) and Rifapentine (Sanofi) by their originators. These drugs are procured by the government and available only through NTEP to registered beneficiaries. Over the past 5 or 6 years, patents for all these drugs have expired, except for Pretomanid, and several generic pharmaceutical companies like Lupin, Macleods, Natco, etc. have taken up the production of these drugs, leading to lower costs and more availability in the market. Since they are off-patent, these companies could produce them for the open market as well. The easy availability and low prices of antibiotics in the open market drive private prescriptions, often leading to their injudicious use. This, in turn, promotes the emergence of drug-resistant bacterial strains, ultimately rendering these antibiotics ineffective. With the advent of drug-resistant and extensively drug-resistant strains of bacteria, TB treatment is already facing a crisis which warrants the discovery of newer drugs. Hence, the move of DCGI assumes importance in the journey to combat antimicrobial resistance. Making them conditionally accessible through NTEP would ensure rational use of these drugs. Possible implications of the restriction However, there are certain risks to this decision if implemented in the current context. In the event of a break in the supply chain of NTEP, these drugs would become unavailable for the persons with TB (PwTB) who are supposed to take them regularly, most often daily, without missing the doses. A terrible drug stock-out of anti-TB drugs during 2023-24 is an example of this threat. The stock-out affected almost every State in India and occurred both for DS-TB and DR-TB drugs. PwTB and their families had to run from pillar to post to obtain drugs needed daily for even the most common DS-TB regimen. Since the NTEP centres ran out of stock, a few PwTB who could afford it, sourced drugs from the open market. For persons affected by DR-TB, since drugs were available only through NTEP, they had to take incomplete regimens or miss their doses altogether. Lack of an alternative source to obtain drugs can be detrimental for PwTB if similar situations arise in future. Missed or incomplete doses can lead to delays in cure or no cure, increased risk of development of drug resistance and increased out of pocket expenditure for patients. This also leads to loss of trust in government systems built over several years, and in the larger picture, is a deterrent to our goal of TB elimination. Also Read: Gross mismanagement: On TB drug shortages and India's national TB programme What can be done? The proposition to make newer anti-TB drugs accessible only through NTEP is a welcome move, provided the government ensures a reliable and uninterrupted supply of drugs through the programme. Similar to how the Ni-Kshay dashboard on real-time disease burden in the country is visible to the public, the Ni-Kshay Aushadhi dashboard depicting available stock of drugs should also be made accessible. This would ensure accountability and help public health advocates to forecast and flag any potential drug stock-outs. A high level of vigilance from civil society is required to ensure that stock-outs at the regional level are predicted, prevented or mitigated. The existing TB Mukt Panchayat initiative could be leveraged for the involvement of local self-governments (gram panchayats) in doing the same. Accountability of the programme to provide drugs to all beneficiaries can be attained if people in power are also devoted to the cause. The idea to restrict the availability of newer anti-TB drugs therefore, must be implemented after careful planning and adequate groundwork, in order to prevent any interruption of access to eligible individuals. (Swathi Krishna Njarekkattuvalappil is a public health physician and researcher based in Pune, working in tuberculosis, health policy and systems research. swathikdk@ Parth Sharma is a community physician and a public health researcher based in Delhi.
Malaysian Reserve
04-06-2025
- Business
- Malaysian Reserve
Inaugural Finance Summit from London Blockchain Highlights Real-World Blockchain Innovation
Leading industry figures discuss how blockchain is reshaping the future of finance LONDON, June 4, 2025 /PRNewswire/ — The London Blockchain event series proudly hosted its inaugural Finance Summit on 3 June, a groundbreaking event that brought together world-renowned industry leaders, innovators and decision makers at the intersection of blockchain technology and financial services. Held at Clifford Chance head office in London, and in collaboration with Global Digital Finance (GDF) and European Blockchain Association, the summit offered forward thinking insights into regulation, infrastructure and real world blockchain applications in finance. The day covered a wide variety of topics from blockchain regulation to the convergence of TradFi and DeFi in reshaping the financial landscape. Guests heard insights from speakers and moderators from key institutions such as Standard Charter, UBS, Deutsche Bank, Vodafone and JP Morgan. The event commenced with a welcome address from Diego Ballon Ossio, Partner with Clifford Chance. 'It's great to see crypto professionals and TradFi services experts coming together to develop something new. These sessions demonstrate that we are entering a more sophisticated phase in the digital assets space and the Distributed Ledger Technology (DLT) is poised to become the next technology of choice for financial services' Alex Stein, Conference Director, London Blockchain said, 'The Finance Summit made one thing clear. Blockchain is no longer on the sidelines of finance, it is becoming part of the core infrastructure. From regulatory frameworks to real-world deployments, we are proud to provide a platform where banks, startups, policymakers and innovators can come together to shape the future of financial services.' About the London Blockchain ConferenceUNITING ENTERPRISE, AI & WEB3 At the London Blockchain Conference, we show how Blockchain will change the world and help people see another way to manage data, build scalable on-chain solutions and achieve great things. We do this by creating valuable, insightful, and engaging events that educate and inform, allowing you to connect and network to build strong business relationships. Our conference is the best avenue to see blockchain innovations, big ecosystem announcements, new product launches, technology updates, keynote speeches, panels, and fireside chats from blockchain leaders. Join us and experience it for yourself. Notes to editors: Session highlights: 1. Blockchain Regulation: Latest Insights into Key Regulatory Developments– Moderated by Madeleine Boys, Director of Programmes and Innovation at GDF. Speakers including Laurent Marochini, CEO, Standard Chartered Bank, Luxembourg Reginald Tumusiime, CEO, CapitalSavvy, President, Blockchain Association of Uganda Ron Tarter, Founder & CEO, MNEE Angus Brown, CEO, Minit Money Session highlights: Digital asset regulation has shifted rapidly around the world in the last six months: Regulatory efforts have accelerated rapidly across major jurisdictions over the past six months, with the panel of experts outlining the key developments in the US, EU, Africa, and beyond. The US is seen as less restrictive compared to the EU: The US is seen as more permissive under the current Trump administration, with easier licensing and new laws (e.g., Genius Act, Stable Act) supporting fintech and stablecoins. By comparison, the EU remains a global leader with stricter, more structured rules, especially under the MICA framework, which has been in development since 2018. Africa is making positive steps toward digital asset regulation: Regulation is catching up with fast-growing private-sector adoption. Countries like South Africa, Kenya, Uganda, and Rwanda are actively shaping legal frameworks. There is regulatory fragmentation, but it's not unique to digital assets: Regulations across the world are not fully aligned, and this can lead to fragmentation. However, most jurisdictions share 90% of the same rules. Collaboration and guidance notes are key to bridging gaps. 2. The Convergence of TradFi and DeFi – Moderated by Elise Soucie Watts, Executive Director, Global Digital Finance. Speakers including Adeline Bachellerie, Deputy Director, Innovation and Financial Market Infrastructures, Banque de France Anna Dinescu, Partner, Hilbert Capital Munder Shuhum, Founder and Managing Partner, Pearls Capital Session highlights: Traditional finance and decentralised finance are merging: The gap between traditional and decentralised finance is closing rapidly. Experts believe regulators and businesses should now treat them as part of the same ecosystem. Tech modernisation, not a revolution: Munder Shuhum explained that blockchain and tokenisation should be seen as natural upgrades to existing financial infrastructure, not separate systems. Regulation is still a barrier: Despite positive steps being taken, widespread adoption of decentralised finance is being slowed by regulatory uncertainty. DeFi benefits from TradFi practices: Firms with a traditional finance background are successfully applying their expertise to decentralised finance systems, particularly in real-world asset tokenisation. Not everything needs to be on-chain: The experts warned against using decentralised finance just for novelty. Instead, adoption should be driven by clear, scalable business benefits. 3. The Evolution of Digital Currencies: Navigating the Future of Finance – Moderated by Bilal Jafar, Hedge Fund & Crypto Correspondent, Dow Jones. Speakers including Ray Dillet, Head of Financial Institutions, Bitwise Asset Management Simon Seiter, Former Head of Digital Assets, Hauck Aufhäuser Lampe Privatbankiers, AG Previn Singh, Executive Advisor to Global Digital Finance (GDF) Centre of Competency, Credit Suisse Francesco Roda, Services Digital Asset Risk Director, Citi Bank Joy Adams, Chief Operating Officer Digital Asset, Deutsche Bank Michael R. Blaschke, Global Principal Enterprise Architect, Enterprise Architecture & Advisory, SAP Session highlights: Enterprise adoption of digital assets is not just about disruption: True adoption comes from shifting from hype to serious strategic planning, emphasising change management and risk control rather than just technology leadership. Regulatory attitudes have matured: Blockchain is now viewed as a foundational infrastructure and will connect other megatrends like AI and green energy. Risk management is also evolving Enterprises are encouraged to integrate digital asset risks into existing frameworks instead of isolating them. Lessons from past tech transitions, such as cloud computing, should inform how enterprises handle decentralised finance today. True transformation requires structural change: The experts warned that true organisational change based on blockchain doesn't just mean faster and cheaper processes. Successful adoption depends on managing internal change and aligning blockchain use with new business models. 4. Real-World Applications of Blockchain in Finance – Moderated by Madeline Boys, Director of Programmes and Innovation at GDF. Speakers including David Palmer, Chief Product Officer, Vodafone Emma Lovett, Executive Director – Markets DLT, J.P. Morgan Anthony Clark-Jones, Executive Director, UBS Investment Bank Session highlights: Blockchain in finance is moving from a purely technology focus to real-world applications: This is like using smart contracts for exact settlement times. Key executives need to understand the technology properly: Before it can grow and see widespread adoption. The Bank of England's Digital Security Sandbox has seen significant interest: There are nine firms already involved in testing during the first phase. 5. Blockchain's Impact on Operation Efficiency – Moderated by Previn Singh, Executive Advisor to GDF, Former Head of the Digital Assets & Distributed Ledger Technology (DLT) Centre of Competency, Credit Suisse. Speakers including Anand Paul, Independent Expert, Former Project Lead of Blockchain Securities Lending Production, Credit Suisse Nadine Teychenne, Global Head of Digital Assets, Investor and Issuer Services, Citigroup Centre Micheal R. Blaschke, Global Principal Enterprise Architect, Enterprise Architecture & Advisory, SAP Session highlights: Blockchain can make transaction lifecycles, compliance, and auditing far more efficient: This reduces settlement times and enabling real-time data sharing. Collateral management and remittances benefit from blockchain: Happens through faster movement, automation with smart contracts, and the use of stablecoins. Blockchain reduces the need for outsourcing back-office functions: Bringing cost savings and efficiency to finance houses. 6. Strategies for Blockchain Integration in Financial Services – Moderated by Alex Stein, Conference Director, London Blockchain Conference. Speakers including Ciarán McGonagle, Chief Legal & Product Officer, Tokenovate Sonia Chawla, Head of Legal Investment Transactions, Schroder Thomas Giacomo, Head of Payments Division, Teranode Group Riccardo Donega, Innovation Product Manager, DLT Digital Assets, Banca Sella Session highlights: Developing standards and aligning with regulations is key for blockchain adoption: Legal clarity is needed around tokenised assets and smart contracts. Fintechs often drive innovation in blockchain: As the industry works together toward regulatory certainty, bigger banks will slowly adopt Firms should speak to everyone from regulators to competitors: As there is a need for clarity around blockchain adoption. 7. Future-Proofing Financial Institutions with Blockchain – Moderated by Adriana Ennab, Executive in Residence, GDF. Speakers including Sabih Behzad, Head of Digital Assets & Currencies Transformation, Deutsche Bank Ray Dillet, Head of Financial Institutions, Bitwise Asset Management Brett Johnson, Head of Sales, Rekord AG Session highlights: Government friendliness has driven adoption of blockchain in the last 12–18 months: This has happened through clear support from the US and more regulatory clarity from the EU. Large institutions face inertia: However, blockchain is now solving real problems like collateral management and saving banks millions of pounds. Retail groups and fintech's take the initial risks: This makes it easier for banks to adopt proven blockchain technologies later. Photo: View original content:
Time of India
17-05-2025
- Politics
- Time of India
Guyanese soldiers face attacks in disputed Essequibo region, tension with Venezuela soar
Guyanese troops came under attack three times within 24 hours this week while patrolling the contested Essequibo region, the country's Defence Force reported. The attacks mark a sharp escalation in tensions with Venezuela just days before a controversial election Caracas plans to hold in the disputed oil-rich territory. Within 24 hours, they faced three separate attacks by unidentified armed men in civilian clothing, according to the Guyana Defence Force (GDF). Though no injuries were reported, the incidents mark a dangerous flare-up in a long-standing dispute between Guyana and Venezuela over this oil-rich stretch of land. The Essequibo region, home to about 125,000 people, accounts for nearly two-thirds of Guyana's territory and lies at the heart of what is becoming a regional flashpoint. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Cyberjaya: Unsold Furniture Liquidation 2024 (Prices May Surprise You) Unsold Furniture | Search Ads Learn More Undo Also read: Latin America mourns world's 'poorest president' Mujica, dead at 89 Essequibo attacks heighten regional instability Live Events The GDF confirmed that the attacks occurred along the Cuyuní River, a key frontier in the contested territory. Though the soldiers executed what the GDF called 'measured responses,' the pattern of aggression is setting off alarm bells in Georgetown and beyond. 'The Guyana Defence Force remains resolute in its mission to protect Guyana's territorial integrity,' the military said in a statement, reaffirming its commitment to 'take all necessary measures' to defend its borders. The timing of the attacks coincides with a controversial Venezuelan plan to include the Essequibo region in gubernatorial elections scheduled for May 25. This move comes in defiance of a United Nations court order instructing Caracas not to proceed with any such vote in the disputed territory. Oil reserves and old claims fuel modern conflict The century-old boundary quarrel reignited in 2015 when ExxonMobil uncovered massive oil deposits off the Essequibo coast. Since then, Guyana has emerged as a major player in the global energy sector, now holding the world's highest crude oil reserves per capita. For Venezuela, whose economy is mired in crisis, the prospect of annexing Essequibo offers both nationalistic appeal and potential economic lifeline. Also read: China commits $10 billion in fresh credit to Latin America Venezuela bases its claim on a boundary it asserts was historically recognized as far back as 1777, arguing that the Essequibo River is the rightful border. Guyana, meanwhile, stands by the ruling of a 1899 arbitration panel, which awarded the region to then British Guiana. The dispute reached new heights in 2023 when Guyana auctioned oil blocks in the area, prompting Venezuela to conduct a referendum and threaten to make Essequibo its 24th state. Despite international condemnation, Venezuela has moved forward with plans that Guyanese officials call illegal and dangerous. Growing concern despite diplomatic promises Although a December 2023 meeting between the presidents of both countries in Saint Vincent and the Grenadines ended with a commitment to avoid military conflict, the fragile peace is now being tested. In February, six Guyanese soldiers were wounded in an ambush, further deepening concerns. The Guyanese government has repeatedly turned to international bodies, including the UN and the International Court of Justice, to resolve the conflict diplomatically. But with border patrols now facing live threats and regional elections looming, tensions on the ground may outpace political resolutions. Also read: In South America, Trump already losing a trade battle with China For the people of Essequibo, the rising instability is a chilling reminder of how quickly international disputes can ripple into their daily lives. Once a remote frontier known for its biodiversity, the region is now drawing global attention not for its natural beauty, but for the oil beneath its soil and the geopolitics above it.
Int'l Business Times
15-05-2025
- Politics
- Int'l Business Times
Guyana Says Soldiers Attacked In Disputed Border Region With Venezuela
Guyana said Thursday its soldiers had come under attack three times in 24 hours in a disputed oil-rich border region where neighbor Venezuela plans to hold elections this month. Armed men in civilian clothing carried out three separate attacks on troops conducting patrols on the Cuyuni River in the disputed Essequibo region, the Guyana Defence Force (GDF) said. "On each occasion, the Guyana Defence Force executed a measured response, and no rank sustained any injuries," it said in a statement, vowing to "continue to respond to acts of aggression along the Guyana-Venezuela border." Both countries lay claim to Essequibo, which makes up two-thirds of Guyana's territory and is home to 125,000 of its 800,000 citizens. Guyana has administered the region for decades, and insists Essequibo's frontiers were determined by an arbitration panel in 1899. The Guyanese foreign ministry said it had condemned the attacks in a diplomatic note to Venezuelan authorities and asked that it launch an investigation "so that the perpetrators are arrested and brought to justice." Venezuela claims the Essequibo River to the region's east forms a natural border recognized as far back as 1777. The long-running squabble was revived in 2015 after US energy giant ExxonMobil discovered huge crude reserves in Essequibo and reached fever pitch in 2023 when Georgetown started auctioning off oil blocks in the region. The find gave Guyana, a small English-speaking former British and Dutch colony, the largest crude oil reserves per capita in the world. Caracas has since held a referendum asserting its claim to the territory, and has threatened to annex most of the region and make it Venezuela's 24th state. It has also announced Essequibo will be included in gubernatorial elections planned for May 25, despite the UN's top court ordering it not to organize a vote there. The GDF said Thursday it "remains resolute in its mission to protect Guyana's territorial integrity" and was taking "all necessary measures to safeguard the nation's borders and maintain peace and security within our beloved country." Tensions calmed after the two countries' presidents agreed in Saint Vincent and the Grenadines last December 2023 to avoid any use of force, but were fanned again in February when Guyana said six of its soldiers were wounded in an ambush in the region.
France 24
15-05-2025
- Politics
- France 24
Guyana says soldiers attacked in disputed border region with Venezuela
Armed men in civilian clothing carried out three separate attacks on troops conducting patrols on the Cuyuni River in the disputed Essequibo region, the Guyana Defence Force (GDF) said. "On each occasion, the Guyana Defence Force executed a measured response, and no rank sustained any injuries," said a statement vowing it will "continue to respond to acts of aggression along the Guyana-Venezuela border." Both countries lay claim to Essequibo, which makes up two-thirds of Guyana's territory and is home to 125,000 of its 800,000 citizens. Guyana has administered the region for decades, and insists Essequibo's frontiers were determined by an arbitration panel in 1899. Venezuela claims the Essequibo River to the region's east forms a natural border recognized as far back as 1777. The long-running squabble was revived in 2015 after US energy giant ExxonMobil discovered huge crude reserves in Essequibo and reached fever pitch in 2023 when Georgetown started auctioning off oil blocks in the region. The find gave Guyana, a small English-speaking former British and Dutch colony, the largest crude oil reserves per capita in the world. Caracas has since held a referendum asserting its claim to the territory, and has threatened to annex most of the region and make it Venezuela's 24th state. It has also announced Essequibo will be included in gubernatorial elections planned for May 25, despite the UN's top court ordering it not organize a vote there. The GDF said Thursday it "remains resolute in its mission to protect Guyana's territorial integrity" and was taking "all necessary measures to safeguard the nation's borders and maintain peace and security within our beloved country." Tensions calmed after the two countries' presidents agreed in Saint Vincent and the Grenadines last December 2023 to avoid any use of force, but were fanned again in February when Guyana said six of its soldiers were wounded in an ambush in the region.
