MUMBAI: The 19-year-old multi-drug resistant TB patient from Patna who won a court battle for access to a newer TB drug, bedaquiline , died in a city hospital last month even though she was responding to the new treatment. Family friends said her lungs had got severely scarred and damaged by the delay in getting the right treatment at the right time.She breathed her last at the casualty at Hinduja Hospital in Mahim where she was brought gasping for breath, said her treating physician Dr Zarir Udwadia , while delivering the keynote address at an event, ‘Outbreak-Epidemic in a Connected World’, to commemorate the 100th anniversary of the Spanish flu. The Patna patient had turned culture negative. However, the doctor said, her lungs had been ravaged by fibrosis and she was on oxygen support. “This girl had moved the Delhi high court when she was refused the drug by a Delhi hospital…She had a miserable end,” he said. Dr Udwadia, who is credited with identifying totally drug-resistant TB cases in Mumbai in 2012, has time and again said that access to bedaquiline is poor in India and barely reaches 4% of the patients who need it.Calling bedaquiline a game changer, he said it was unfortu-nate that patients in India, where the drug is manufactured and supplied the world over, do-n’t have unconditional access to it as the government fears a “catastrophic spread of resistance” if used without discretion.Under the circumstances, Dr Udwadia said, India would not be able to eradicate TB by WHO’s 2030 deadline. “We have the most cases in the world. TB kills one Indian every two minutes. All this optimistic talk of eradicating TB by 2030 and then by 2025 by the PM makes me amused and then angry,” he said. The initial national TB programme was a disaster, under-funded and wasn’t working. “It was revised about 30 years later and we embraced DOTS. But a one-size-fits-all programme is only likely to amplify the problem.”Dr Udwadia said India’s TB programme has to improve in many departments. “Drugs are not available and there is a public policy paralysis,” he said, underlining that the progra-mme has to ensure that Gene-x-pert machines, new drugs and vaccines are added to the regime. “The programme is underfunded by $1.6 billion a year.”Previous studies by Hinduja Hospital have shown that an average TB patient is diagnosed two months after the symptoms show up, while MDR patients lose an average of six months before the right diagnosis.

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