Treating drug resistant TB can take years and can cost 200 times as much as treating ordinary diseases. Approval for the drug Bedaquiline marks the first time in 40 years that FDA has approved the drug that attacks TB in different ways from current treatment. Discovered by scientists at Janssen, the pharmaceuticals unit of Johnson & Johnson, Monday saw the roll out of this ‘miracle drug’.
Sunil Khaparde, Deputy Director General, Central TB division, Union Health Ministry told The Indian Express that initially 600 doses will be procured under the Conditional Access programme from Johnson & Johnson and then another 2,000 doses from USAID. The drug will be given under strict supervision at six government hospitals across the country including KEM hospital in Mumbai. The drug will be rolled out as a pilot project at Delhi, Chennai, Ahmedabad and Guwahati.
The drug was prepared in response to the World Health Organization’s call in 2012 to work on anti TB medication. While trials in Africa have shown promising results, experts admit that not much research has been undertaken now on anti-microbials of any type. “So when a new drug that shows good results against TB is in the public domain, there are huge expectations. Let’s hope the drug works as the bacteria is acting fast,” said a reputed microbiologist at B J Medical College and Sassoon General Hospital in Pune.
Bedaquiline is a promising new TB drug but it must be carefully introduced and monitored said Dr Madhukar Pai, Director of McGill Global Health Programme, Canada.“I have already seen media reports from India which call Bedaquiline a ‘miracle drug’. This worries me – terms like ‘miracle drug’ should not be used lightly as it can raise expectations and also encourage abuse. More evidence is needed on how Bedaquiline fits in with existing and other new drug regimens. It is not intended to be used alone,” Pai explained.
TB remains a global epidemic with over two billion people harbouring its latent infection and more than 9 million cases of which five lakh are multi-drug resistant (MDR-TB). India accounts for 23 per cent of global TB cases and deaths. An estimated 2.2 million people suffer from TB in India with over 70,000 MDR TB patients.
According to Dr Soumya Swaminathan, Director General of Indian Council of Medical Research (ICMR), drug resistant TB is a huge challenge. Bedaquiline targets a new protein of bacteria (causing TB) and is effective in the case of MDR-TB.
Several activists have pointed out that launching Bedaquiline is welcome but more than half the TB patients in India seek care in the private sector and private healthcare providers are often the first point-of-care even for patients who are eventually treated in the public sector. Therefore, it is imperative that the government engages with private health care providers to ensure that every TB patient is accorded the recommended diagnosis and treatment regimen.