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We couldn’t help but notice the many pundits on TV gaining a sudden interest in discussing the pros and cons of investing in a universal healthcare scheme last week post the budget announcement, even more than when it was first announced. While we are sure the budget kept you engaged as well, the last few weeks were pretty busy for us too.

On February 25, we inaugurated our new advanced HIV treatment centre at the Guru Gobind Singh Hospital in Patna. This is a first of its kind project for MSF in India. The project aims to provide comprehensive care to the most vulnerable population living with HIV in the state, battling the most severe stages of the infection. 

We assessed the need for the project basis our own research that showed around 10 to 15 per cent of people living with HIV in the state in need of specialised care and attention. The model of care we adopted for this new project will prioritise quality of life and dignity for people living with HIV along with ensuring a reduction in the number of deaths among patients through providing care for various life-threatening infections. We also trust and hope other actors in the state adopt a similar model of care to treat advanced HIV.
 
MSF's holistic care centre for patients with advanced HIV at the Guru Gobind Singh Hospital in  Patna, Bihar. Copyright: MSF
 
MSF will also build capacity among hospital staff and support the Ministry of Health with the management of advanced cases of HIV. Our teams will also evaluate and advocate for innovative diagnostic tools and treatment for people living with HIV not just in Bihar, but across India. The project will also involve mentoring medical staff working for the Bihar State AIDS Control Society and the hospital where our ward is located.
This isn’t our first project in Bihar. MSF has been present in Bihar since 2007 in collaboration with the Rajendra Memorial Research Institute and the government of Bihar working on treating kala azar and kala azar-HIV co-infections in Patna.  Our teams have experience working across the state to raise awareness about the challenges and complications of co-infections and providing psychosocial support.
February has also kept us busy.  Last week, MSF supported two TB survivors with their patent challenge against pharmaceutical giant Johnson and Johnson for their patent on bedaquiline. The Access Campaign team has been working tirelessly with the petitioners on their patent opposition. The J&J patent application being challenged is for the salt form of bedaquiline, which does not merit patenting under India’s patent law. If granted, J&J’s monopoly on bedaquiline would be extended from 2023 to 2027, delaying entry of generics by four additional years.
Both the petitioners, Nandita Venkatesan from Mumbai, India and Phumeza Tisile from Khayelitsha, South Africa have insightful stories to share regarding their fight against drug-resistant tuberculosis. Their stories have important lessons that, if we don’t heed, could have far-reaching consequences. Both survivors had lost their hearing because of the toxicity of the treatment for drug-resistant tuberculosis and are now advocating to ensure that newer drugs like bedaquiline – which are safer and more effective – are made affordable and accessible to everybody with DR-TB and replaces the painful and toxic drugs that are currently used. The cure rate for present treatments is only 55 per cent. “The evidence of improved cure rates and lives saved for people with drug-resistant TB using bedaquiline is crystal clear,” said Dr Anja Reuter, a DR-TB doctor with MSF in Khayelitsha, South Africa,
 
“I lost my hearing when I was 24 because of the brutal side effect of an injected DR-TB drug,”
                                                                                -Nandita Venkatesan, DR-TB survivor
 
 “I was devastated by this loss, which took a heavy financial, emotional and mental toll on me. How many more people will have to die or go deaf, waiting to access safer and more effective drugs that can save their lives without such devastating side effects? With this patent challenge, we want to prevent an extension of the patent monopoly that will continue to block people from accessing more affordable generic versions of bedaquiline.” said Nandita Venkatesan, who completed her treatment in 2015.
 

Phumeza also has a similar experience with injectables for treating DR-TB. “I know what it means to be faced with the choice of being deaf or dead because the only drugs that can save your life will also rob you of your hearing. I wouldn't wish anyone to go through what I did with DR-TB. Pharmaceutical corporations like J&J should stop controlling the price of the drug that will restrict people’s access to safer and more effective tuberculosis treatment.” Phumeza completed her DR-TB treatment in 2013, which included injected drugs.
While mentioning drug patents, it is important to point out the research behind the the development of the drug. Bedaquiline development benefitted considerably from public investment, and the evidence for its potential to improve cure rates with fewer side-effects was the result of a collective effort of the global TB community. MSF will continue to urge J&J to refrain from attempts to extend its monopoly that will further delay the availability of quality-assured generic versions of bedaquiline in India, South Africa and other countries.
We also have an important announcement from our project in the neighboring state of Bangladesh. Between August 2017 and December 2018, MSF provided one million medical consultations to refugees and the local community in Bangladesh. August 2017 marked the start of more than 700,000 Rohingya refugees fleeing violence in Myanmar for safety in Bangladesh.  Today, nearly one million Rohingya refugees live in camps and makeshift settlements across Bangladesh’s Cox’s Bazar peninsula.  There were several observations from our consultations; many diseases were linked to people’s poor living conditions while incidences of chronic diseases, such as diabetes and high blood pressure, were also common among patients. Do check out this video to know more.
 
See you in March!
 
 
Know someone in your newsroom who would be interested in our stories? Click on the link below or email us at aditi.sonrexa@new-delhi.msf.org
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