2 months on, new TB drug plan yet to see the light of day

Two months after the announcement of rolling out of new tuberculosis (TB) drug Bedaquiline in Mumbai, the Brihanmumbai Municipal Corporation (BMC) is yet to start the programme. If sources in the corporation are to be believed, the plan is stuck because doctors are unwilling to join the Sewri TB hospital.

"On the World Tuberculosis Day in March, BMC had announced that they will roll out the Bedaquiline programme by April. Patients have to stay in hospital for at least two weeks during the programme, as they need to be monitored. The corporation is not getting any doctors to monitor these patients," said a doctor, working closely with BMC's TB control programme.

Under the Revised National Tuberculosis Control Programme (RNTCP), Mumbai is one of the six centres across India where Bedaquiline will be given to 100 patients at Sewri TB hospital. The Union health ministry has decided to provide 600 courses of the drug free to patients who are not resistant to the first-line and second-line TB drugs. Used in the US, Bedaquiline can reduce the multi-drug resistant TB treatment by two months. At present, India has 65,000 MDR-TB patients and 2,500 XDR-TB patients.

While the corporation is struggling to even start the project, earlier this month, Guwahati became the first city in India to roll out the programme. "The drug has adverse side-effects. It can affect functioning of the heart. It is a 24-week course. The patient will be kept under observation in the hospital for initial 15 days to two months of the treatment to monitor how they react to the drug," said the doctor. The miracle drug is known to have a range of side-effects, including nausea, liver toxicity and chest pain.

He said there was a shortage of doctors at the Sewri TB hospital and the corporation was making all efforts to recruit more people. "Many are not keen to take up the job because of the fear of contracting TB. We have been experiencing this problem for a long time now," said a source from the Sewri TB hospital – Asia's largest TB hospital.

Admitting the problem of staff shortage, Mumbai TB officer Dr Daksha Shah said, "It is one of the reasons behind the delay. We have advertised for the posts though." She added that the plan was further delayed because they were yet to finalise the list of patients who will be put on Bedaquiline treatment. "We are waiting for patients' report. They have been tested for sensitivity for all the 11 anti-TB drugs. The selection process is quiet rigorous." She said if everything fell in place, they will be able to roll out the programme by end of June or July first week.

As per BMC, for the first two months, the selected cohort of patients will be provided Bedaquiline daily. Then for the next six months, they will be subjected to an intermittent dose of the drug thrice a week.