Challenges in access to novel IgA nephropathy therapeutics in South Asia

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.