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Tuberculosis
It’s been a while since we shared some good news with you. The Indian government has just recently announced it would roll out an all-oral treatment regimen for multi-drug-resistant tuberculosis (MDR-TB) across the country, replacing the harmful injectables presently used for treatment. While the government has taken several positive steps to reduce the public health burden of tuberculosis (TB), barriers to treatment still exist. 

“The dream of an injectable free regimen is not possible for all drug-resistant tuberculosis patients - particularly those with fluoroquinolone resistance – until both bedaquiline and delamanid - are made available together for patients with extensively drug-resistant tuberculosis (XDR-TB) and pre- XDR-TB patients,” said Leena Menghaney, Head, India & South Asia, MSF Access Campaign.  “The other key factor is the price of delamanid today, which is $1700 for a six month regimen.  This price makes it difficult for TB programmes to scale up the drug,” Menghaney added.

We are bringing our advocacy messages around access to medicines and other issues related to TB at the 50^th Union World Conference on Lung Health in Hyderabad between October 30 and November 2. The conference will host delegates from across the world including civil society, public health experts and TB activists. MSF will present various reports and hold workshops during the conference to advocate for better access to treatment for DR-TB, including drugs and diagnostics. Ahead of the conference, we will also organise a protest to lower the price of bedaquiline to $1 a day in various countries including India.  Do connect with us if you plan to attend the event.

Climate Change
The United Nations Climate Action Summit held last month focused on the urgent need to cut down on carbon footprint. At MSF, we have always factored in the potential for extreme weather events and the spread of vector-borne diseases, of drought, desertification, and mass displacement, something that is clearly on the rise in the last decade.  Across MSF projects, teams are exploring ways to cut our carbon footprint—like using less diesel as fuel and relying less on air travel for people and cargo. We’ve also tested the use of solar panels to power our facilities in places like Democratic Republic of Congo and Haiti, and we’re also building an energy efficient hospital in Sierra Leone.

While we must play our part, it is vital for governments and polluting industries to slash greenhouse gas emissions and limit global warming. It is also critical that we address the environmental challenges facing us today before they contribute to multiplying humanitarian catastrophes in the future. Earlier this year, Mozambique was hit by two cyclones in a single season, the first time in recorded history. Worldwide, the incidence of dengue has also increased 30-fold over the last half century, with approximately 390 million infections in 2010, partly due to warming temperatures and the associated spread of the mosquito species that carry and spread the disease. You can read more about the link between climate change and our experience in treating the most vulnerable populations in various countries here.

Kashmir
It’s been nearly two months since the total lockdown in Kashmir.  People’s lives are still very much affected. Our teams on the ground report that people fear to move freely. They remain isolated with very limited phone connectivity, transport options and irregular hours for trade. After a brief halt in our activities, our teams have resumed our counselling work.  In the first ten days of September, we provided counselling assistance to some 40 patients in Sopore & Baramulla, 75 patients in Pulwama and 36 patients in JLNM in the capital city Srinagar. We are also assessing other humanitarian needs and are ready to respond accordingly. Since we continue to receive multiple queries regarding our operations in Kashmir ever since the lockdown, we have updated our statement that best reflects the situation on ground:

“The most vulnerable cannot be left without adequate humanitarian assistance. As this recent crisis prolongs, it disproportionately affects the mental health of the people, who have been living through the decades-long conflict in Kashmir. Médecins Sans Frontières / Doctors Without Borders (MSF) is committed to bringing medical care to the most vulnerable people in the world - and we urge that people have uninterrupted access to health care in Kashmir," said, Annemarie Loof, MSF’s operational manager for India.

US-India trade deal
India is currently facing pressure from the US, the European Union, Switzerland, and Japan, backed by multinational pharmaceutical companies, to change its intellectual property (IP) policies to offer more monopoly protections to multinational pharmaceutical companies at the expense of public health safeguards. If the Indian Government caved into this pressure, it could severely restrict access to affordable medicines in the future, and could be disastrous for millions of people around the world and for treatment providers like MSF, who rely on affordable Indian generic medicines.

Last month, ahead of the Prime Minister Narendra Modi’s visit to US to discuss a ‘trade-package’ with US President Donald Trump, MSF urged the Indian government to not make any commitments regarding intellectual property (IP) that would impact millions of people who rely on affordable generic medicines produced in India. India supplies affordable generic medicines to people and governments worldwide, including to MSF’s medical humanitarian projects, which are present in more than 70 countries. While we do not know what transpired in the meeting between the two nations, going by past experiences, the focus of the United States in free trade agreements has been a demand for stronger IP provisions. MSF’s Access Campaign has repeatedly expressed concerns over the use of free trade agreements as a platform to push for excessive intellectual property measures that would jeopardize India’s ability to produce and supply affordable generic products. You can read more about it here.
 
“India should be cautious while signing any trade package or launching trade negotiations with the US that may include harmful provisions threatening India’s ability to produce and supply affordable medical products.  The world can’t afford to see India’s pharmacy shut down to protect the profiteering of U.S. pharmaceutical corporations, " said Leena Menghaney, Head- India & South Asia, MSF Access Campaign. We also have some interesting events coming up next month, including a live interaction on facebook on World Mental Health Day.  If you have previously reported on or worked in the field of mental health, do get in touch!