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Peer-reviewedCC BY-NC-ND 4.0The Lancet Regional Health - Southeast Asia

Challenges in access to novel IgA nephropathy therapeutics in South Asia

  • Sana Shadab1
  • Shyam Bihari Bansal2
  • Eranga Wijewickrama3
  • Muhammad Rafiqul Alam4
  • Dibya Singh Shah5
  • Soumita Bagchi6,7,8
8 affiliations
  1. 1Department of Nephrology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
  2. 2Department of Nephrology, Medanta Kidney and Urology Institute, Medanta Hospital, Gurugram, Haryana, India
  3. 3Faculty of Medicine, Department of Clinical Medicine, University of Colombo, Colombo, Sri Lanka
  4. 4Consultant, Kidney Centre, Green Life Medical College & Hospital, Dhaka, Bangladesh
  5. 5Department of Nephrology and Transplantation Medicine, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
  6. 6Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
  7. 7Centre for Kidney Research, Westmead Hospital, Sydney, Australia
  8. 8Sydney School of Public Health, Australia
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Abstract

IgA nephropathy (IgAN) is a major cause of chronic kidney disease in South Asia, particularly among young adults. Although recent therapeutic advances have transformed IgAN management globally, access to these treatments in South Asia remains limited. Most patients continue to rely on supportive care and conventional immunosuppressives, which have limited efficacy and significant adverse effects. Multiple barriers hinder implementation of newer therapies, including shortage of healthcare capacity and specialist nephrology care leading to delayed diagnosis, high treatment costs, limited resources, lack of universal health coverage, regulatory challenges, and underrepresentation of South Asian populations in clinical trials. This viewpoint discusses the current landscape of IgAN management in South Asia and outlines strategies to improve equitable access to novel therapies, including strengthening healthcare infrastructure and workforce, expanding screening and diagnostic capacity, implementing pricing and reimbursement reforms, facilitating clinical trials and local evidence generation, improving disease awareness in the community as well as healthcare professionals, and enhancing stakeholder advocacy and policy engagement.

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Cite

BibTeXRIS
BibTeX
@article{shadab2026challenges,
  title = {{Challenges in access to novel IgA nephropathy therapeutics in South Asia}},
  author = {Sana Shadab and Shyam Bihari Bansal and Eranga Wijewickrama and Muhammad Rafiqul Alam and Dibya Singh Shah and Soumita Bagchi},
  journal = {The Lancet Regional Health - Southeast Asia},
  year = {2026},
  month = jul,
  doi = {10.1016/j.lansea.2026.100812},
  url = {https://doi.org/10.1016/j.lansea.2026.100812},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Challenges in access to novel IgA nephropathy therapeutics in South Asia
AU  - Sana Shadab
AU  - Shyam Bihari Bansal
AU  - Eranga Wijewickrama
AU  - Muhammad Rafiqul Alam
AU  - Dibya Singh Shah
AU  - Soumita Bagchi
PY  - 2026
DA  - 2026/07/22
JO  - The Lancet Regional Health - Southeast Asia
DO  - 10.1016/j.lansea.2026.100812
UR  - https://doi.org/10.1016/j.lansea.2026.100812
AB  - IgA nephropathy (IgAN) is a major cause of chronic kidney disease in South Asia, particularly among young adults. Although recent therapeutic advances have transformed IgAN management globally, access to these treatments in South Asia remains limited. Most patients continue to rely on supportive care and conventional immunosuppressives, which have limited efficacy and significant adverse effects. Multiple barriers hinder implementation of newer therapies, including shortage of healthcare capacity and specialist nephrology care leading to delayed diagnosis, high treatment costs, limited resources, lack of universal health coverage, regulatory challenges, and underrepresentation of South Asian populations in clinical trials. This viewpoint discusses the current landscape of IgAN management in South Asia and outlines strategies to improve equitable access to novel therapies, including strengthening healthcare infrastructure and workforce, expanding screening and diagnostic capacity, implementing pricing and reimbursement reforms, facilitating clinical trials and local evidence generation, improving disease awareness in the community as well as healthcare professionals, and enhancing stakeholder advocacy and policy engagement.
SN  - 2772-3682
ER  -