At a time when activists are demanding a wider rollout of bedaquiline, one of the two new anti-tuberculosis drugs, only 276 patients have received it since January 2016.
According to the Brihanmumbai Municipal Corporation, 24 of these patients, who are on combination of bedaquiline and other anti-TB drugs, have reported side effects like abdominal pain, anaemia, depression, electrolyte imbalance, liver dysfunction and increased uric acid. Replying to an RTI query filed by Chetan Kothari, civic officials said, “Bedaquiline is given in combination with other anti-TB drugs. Thus the side effects of bedaquiline are not observed separately.”
Bedaquiline is one of the two newest anti TB drugs in 50 years, the other one being delamanid. The drug is supplied under the conditional access programme after each patient is evaluated to be put on the drug. The Centre has a restrictive policy of giving bedaquiline under the Revised National Tuberculosis Control Programme. A primary criterion is that the patient has to be sensitive for at least three drugs in the background regimen. In a Lancet article, chest physician Dr. Zarir Udwadia argued that the clause denies this drug to the very patients who would benefit the most from it.
Dr. Udwadia, who is at the helm of P.D. Hinduja Hospital’s TB clinic and the first one in the country to access the drug for a patient on compassionate grounds in 2013, said less than 4% multi-drug resistant and extensively drug resistant TB patients who will benefit from the drug are actually receiving it. Last month, Medicines Sans Frontiers wrote an open letter to drug maker Johnson & Johnson asking for an affordable and sustainable supply of bedaquiline to treat more patients.