TB care in Mumbai, India: New drugs, new hope

22 Mar 19

Drug-resistant TB (DR-TB) is a growing public health threat. Diagnosing DR-TB is difficult. Few people with DR-TB are diagnosed and started on treatment. Standard treatments for DR-TB can take up to two years and can have severe side effects, including deafness and psychosis; they also have low cure rates. A growing body of evidence shows that treatment regimens containing the newer DR-TB drugs bedaquiline and/or delamanid are more beneficial to patients who have complex resistant strain with limited or no drugs available. However, these medicines still remain inaccessible to many, few receiving either drug under (national) conditional access programme only for 6months. MSF wishes to highlight the work on DR TB it does in Mumbai, India, and explain through staff and patient interviews what some of the biggest issues are.

MSF offers free individualised treatment regimens for people living with HIV and individuals with severe forms of drug-resistant TB at its independent private clinic in Mumbai. The facility provides ambulatory medical and psychosocial care for patients with very complex TB resistance patterns (resistant to many or nearly all available TB drugs), who require treatment regimens which are not available in the public sector. Most patients seen by MSF have often previously been treated with ineffective regimens for several years by public and private practitioners. Some are also believed to have been directly infected in the community by extensively resistant strains.

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