Medical ethics

Hospital against access to life-saving drug for TB patient as case reaches Delhi High Court

The hospital administration said the 18-year-old woman could develop ‘an additional and fatal resistance to bedaquiline, which may spread to the community’.

Officials from the National Institute of Tuberculosis and Respiratory Diseases on Monday told the Delhi High Court that providing bedaquiline, a life-saving drug, to an 18-year-old woman suffering from a drug-resistant form of TB would fail to treat her. They warned that it may cause the drug-resistant bacteria to spread in her body.

The patient, a Patna resident, has already developed a resistance to all other available drugs to treat TB. She has been undergoing treatment for the disease since 2013. Her father had moved the Delhi High Court, seeking access to bedaquiline, which is provided conditionally at six hospitals in five cities, including at the institute.

The hospital screens each patient before giving the drug and then monitors them. The woman was denied the treatment initially as she was not a resident of Delhi. wrote about her plight and how her treatment reflects the failure of the national TB programme. The woman is currently being treated at PD Hinduja Hospital in Mumbai.

An affidavit filed by Vijay Bhatt, the hospital’s administrative officer, said that with an “inefficient backbone regimen” (drugs that should be taken along with bedaquiline), the patient could develop “an additional and fatal resistance to the drug, which may spread to the community and have catastrophic effects.”

The hospital administration insisted on a drug sensitivity test, which could take up to two months. A sample for the test has already been taken. “If they say this drug will not work, could they at least tell us what will cure my daughter?” said the woman’s father, who was present at the Delhi High Court. The next hearing in the case is scheduled for Friday.

Earlier, Dr Jennifer Furin, from the Global Health and Social Medicine at Harvard Medical School, had said that the patient’s previous reports are indicative enough for her to be eligible for bedaquiline. An additional test would be a “bureaucratic requirement and not in the best interests of the patient”, she had said.

The hospital has also asked the patient to try and get the drug from the manufacturer, Janssen Pharmaceuticals, which could provide the medicine free of cost to patients if the doctor provides evidence that the patients will die without it. However, in practice, it could take two to three months for a patient to get access to the drug through this avenue.

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