BENGALURU: Even as Tuberculosis (TB) activists are protesting for access to life-saving drugs Bedaquiline and Delaminid, in the national capital, in the backdrop of the End-TB Summit in Delhi to be held on Tuesday, 120 courses of Bedaquiline reached Bengaluru recently.India has only 1,000 doses of Bedaquiline, obtained as donations from manufacturers for multidrug-resistant tuberculosis (MDR-TB) patients. According to the union health ministry, only around 81 patients are on Delaminid in seven states and union territories. Doctors have written to Prime Minister Narendra Modi to make the drugs accessible to more patients.
The existing MDR-TB drugs like Kanamycin cause hearing loss and these newer drugs are a boon that are available only on conditional access (not available in open market) with the Government of India. At least 120 patients among the 1,000 MDR-TB patients in Karnataka have complex TB who are not responsive to any of the existing drugs and will be put on Bedaquiline. However, Delaminid is yet to reach Karnataka.
These patients will now be treated in six MDR-TB nodal centres of the state. In Mangaluru, Mysuru, Kalaburagi, Bengaluru, Dharwad and Ballari. TB patients being treated by private practitioners should approach these nodal centres for the drug if their doctors haven’t notified their disease to the government yet.
Dr Ramachandra Bairy, joint director, Tuberculosis, department of health and family welfare, told The New Indian Express, “A committee will be set up consisting of physicians who will check if Bedaquiline can be given to them. Drugs for MDR TB are extremely expensive and toxic, and a patient cannot bear the costs privately. Doctors have also been trained from the state to treat Delaminid and it will be shortly available. Karnataka is one of the seven states chosen for it.”
A health department official on the condition of anonymity said, “In 2017, 69,000 TB patients were diagnosed and 1,000 patients were diagnosed with MDR TB. Previously, we did not have the labs to diagnose resistance to fluoroquinolone drugs and second-line injectable drugs. Now, we have three labs in Raichur Institute of Medical Sciences, Kempegowda Institute of Medical Sciences, Hubbali and IRL, Bengaluru. Even if they are found to be resistant to one of these two drugs they are eligible for Bedaquiline.”
Bedaquiline should be given for a maximum of six months on top of the WHO recommended combination treatment regimen. The manufacturer recommends 400 mg daily (4 tablets) for 2 weeks followed by 200 mg 3 times per week for the remaining 22 weeks. “The drugs are given in combination with other drugs not individually. The patients have to be admitted to these centres for first two weeks as they can develop side effects like cardiac arrhythmias that need to be monitored using ECG machines. They need to be meticulously monitored,” the official said.