International organisation Doctors Without Borders aka MSF (Médecins Sans Frontières) is giving tuberculosis patients access to life-saving combination of bedaquiline and delamanid
Thirty two — that's the number of extremely drug-resistant tuberculosis (TB) patients in India who are getting access under the 'combo regime' to two life-saving TB drugs — bedaquiline and delamanid. These are the last known drugs against the constantly mutating TB bacteria.
"Thirty one patients are getting access to the combo regime on compassionate grounds at the MSF clinic in Govandi. Another 22 are getting delamanid combined with other independent drugs and three are being given bedaquiline," said Dr Pramila Singh, Clinic Manager, MSF, Mumbai.
The combo drugs are being administered since 2016 and most of the patients have shown signs of improvement and are doing well.
India is home to 79,000 drug-resistant TB patients, many of whom are resistant to almost all of the 14 drugs available to treat the infectious disease.
The Patna teenager, whose father moved the Delhi High Court to get her access to bedaquiline is the only other patient to get the combo drugs apart from those who are getting treated at the MSF clinic.
While she was provided bedaquiline under the government's TB programme, MSF provided delamanid. The government provided her bedaquiline on the condition that the doctor treating her replaces the supply once he gets it from the drug's manufacturer, Janssen.
These drugs are permitted only on 'compassionate grounds' and on a case-to-case basis. Bedaquiline is available to 600 patients at six centres under a government programme. It takes up to two to six months for MSF to get the permissions and complete the paperwork required to import these drugs.
"The government programme has been very cautious and slow in rolling out the new drugs," said Dr Stobdan Kalon, Medical Co-ordinator, MSF, India, adding that the country's premier research organisation Indian Council of Medical Research (ICMR) will soon start clinical trials to test the different combination of drugs.
Despite almost 28 lakh people reporting to be suffering from TB every year (highest in the world), India's response to the rapidly spreading resistance continues to remain slow.
Hanif Shaikh, 25, who is one of the patients on the combo regime said, "I was diagnosed with TB in 2011 and since then I went to several hospitals, both private and government. I went to Rajawadi and Sion Hospitals too. Everywhere I went, I was put on a different treatment, but none of them helped in my recovery."
The father of two has been showing signs of recovery finally, following being put on the combo regime. He now works at a shoe shop near Mansarovar railway station in Navi Mumbai.
Dr Zarir Udwadia, TB expert at Hinduja Hospital, who is treating the Patna teenager, stresses on the need for a change in the policy that keeps life-saving drugs away from the patients. "The government's plan to eliminate TB by 2025 almost makes me laugh. It is ambition in the extreme and not practical, to say the least," he said.
"India has 0.4 Gene Xpert machines (that tests drug resistance) for every million patient and only 67 labs that can perform the tests to check the drug's susceptibility," he said.
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