TODAY -

Strike at the root of the problem to kill TB

Shobha Shukla *

Strike at the root of the problem to kill TB



Goodman Makanda, who lives in Khayelitsha - outside of Cape Town in South Africa - was diagnosed with multidrug-resistant TB (MDR-TB) in November 2013, when he was 30 years old. As if this was not enough, after 3 months of treatment, he was told in January 2014 that his MDR-TB had escalated to extremely drug resistant TB (XDR-TB).

These two shocks, coming in such quick succession, not only devastated him mentally, but baffled him too: "I had never contracted any type of TB before. Moreover I did not show any symptoms of TB like coughing, sweating or weight loss. One day, all of a sudden, I just vomited blood. So I went to a private doctor, who directed me to a government clinic. There I was diagnosed first with MDR-TB and then XDR-TB. There were too many unanswered questions in my mind. I had been made to understand that if one did not complete the normal (drug sensitive) TB treatment, then it could lead to MDR-TB. But in my case it was MDR-TB that attacked me directly. I had no clue as to why and how it had happened."

Dual Burden: TB and Diabetes

This was a very stressful period in Makanda’s life. He was on 18 tablets a day plus one painful injection. He was also on insulin because of his diabetes, with which he has been living since 2002. The side effects of TB medication were terrible. He would feel drunk, drowsy, tired, listless, lost his appetite, and would not want to walk or talk to anyone.

Slowly, Makanda came to terms with his predicament. He said to himself: "It is me who is sick, and not the counsellor or the nurse. Once I change my attitude to a positive one, the medication is bound to work. If I am negative in my mind, treatment will also show negative results. So accept yourself for what you are and then everything will fall in place."

Recently, there has been a blessing in disguise in Makanda’s life. He is one of the very few fortunate patients in Khayelitsha who, through the untiring efforts of Médicins Sans Frontières (MSF), have been put on treatment with Delamanid - one of the only two (the other being Bedaquiline) new drugs to become available in the the past 50 years, that are effective against the deadliest strains of the disease, including MDR-TB and XDR-TB.

New TB drug: Delamanid

It is estimated that up to two thirds of the nearly half a million people who acquire drug-resistant TB each year globally could benefit from Delamanid. The drug is particularly important for South Africa, which has one of the highest global burdens of MDR-TB with 18,000 cases diagnosed in 2014. At least 7,000 people a year could benefit from this drug in South Africa, according to WHO guidance for using Delamanid. But, with the Japanese pharmaceutical manufacturer Otsuka, putting a prohibitively high price tag of US$ 1,700 per treatment course for Delamanid, the drug is out of reach for most of those in urgent need of it.

Interestingly, even though South Africa is one of the sites for Otsuka’s clinical trials on Delamanid, the company has still not yet filed for registration of the drug in South Africa. To date, Delamanid is only registered in four countries (Germany, Japan, South Korea, and the United Kingdom). MSF recently gained access from Otsuka to a very limited number of Delamanid treatment courses for use in South Africa, and in the past three months, has started five patients in Khayelitsha on regimens which include the drug, Makanda being one of them.

He has been on Delamanid, in conjunction with other drugs in standard regimen, since November, 2015 and will have to be on it till May 2016, as it has to be taken for 6 months. Within one month of starting on the drug, he felt a remarkable improvement in his condition - "Since I have started taking this medicine, all my debilitating side effects have vanished and you can see how healthy I have become (He indeed was in the pink of health, when I met him in December 2015). But most people still have to continue with the old medication for drug resistant TB and the treatment is very challenging, as was in my case. But I overcame them with sheer will power."

From his personal experience “Ignorance about TB is the biggest bane and stumbling block in controlling it. Due to lack of correct information, there still is a lot of stigma attached with TB. It is a general belief that only people who are dirty or do not get enough food to eat can get TB. This may not be the case always. I was eating healthy food, but still I got it. People forget that TB is in the air. So anyone can get it - rich or poor”.

Makanda is now part of a support group with MSF and as a counsellor he helps other TB patients. “I tell them to talk about their concerns—if you experience something, talk about it. We cannot buy TB from a shop—if we did, we would return it to the shop and say thank you- I do not want it. They love it when I talk to them like this. It helps them to get rid of self stigma. So we have to educate them and talk to them as friends. TB is curable. It can be defeated with proper treatment coupled with a strong will power. This message has to go out loud and clear”.

Makanda’s sane advice is that to control MDR/XDR-TB, we must focus on eliminating drug sensitive TB and ensure that people complete their treatment.

“If we want to end TB, we cannot start by cutting the branches of the tree. If you do not want the tree of TB in your yard, do not merely cut the branches, but cut off the root, so that the tree cannot grow again. MDR/XDR-TB are just the branches of the normal TB tree. I got MDR-TB directly from the air and it was there because someone else interrupted treatment of their normal TB. So let us dig the problem from the ground level, then the branches will die automatically”.

The lack of good and affordable drugs, increasing levels of resistance, and the sheer number and breadth of MDR/XDR-TB cases present a grave global challenge. If left undiagnosed and untreated, the disease will continue to spread and kill. Dr Mario Raviglione, Director of Global TB Programme at the World Health Organization (WHO), too voiced his concerns about the high prices of the two new TB drugs at a webinar (online at: www.bit.ly/mar16-recording ) in the lead up to World TB Day 2016 recently hosted jointly by CNS (Citizen News Service) and the International Union Against Tuberculosis and Lung Disease (The Union). He insisted upon creating a market dynamics which are correct and good and which will allow some of the highly expensive drugs to have a price which is more acceptable.


* Shobha Shukla, Citizen News Service - CNS wrote this article for e-pao.net
The writer can be contacted at ramakantbobby(at)gmail(DOT)com
This article was posted on March 25, 2016.


* Comments posted by users in this discussion thread and other parts of this site are opinions of the individuals posting them (whose user ID is displayed alongside) and not the views of e-pao.net. We strongly recommend that users exercise responsibility, sensitivity and caution over language while writing your opinions which will be seen and read by other users. Please read a complete Guideline on using comments on this website.




LATEST IN E-PAO.NET
  • Inauguration: Sangai Fest #2: Gallery
  • Lanjaichung, Chitnuleima : eMing
  • Protection from Mob Violence Bill, 2018
  • Arbitrary detention of AMSU members
  • CAB: Our safety valve please
  • Training for Para Legal at Bishnupur
  • Inner Line Permit (ILP) Demand : Timeline
  • Assam, Tripura standing alone
  • Mother Courage- synonymous to Nupi Lal
  • Nupi Lan Ningsing Lamjel #1: Gallery
  • Nupi Lan Day (State): Gallery
  • North East is burning hot in cold december
  • CAB 2019 : Proposal & reactions
  • The great cosmic discovery - IV
  • Remembering Dr BR Ambedkar #2
  • Epicentres of CAB protests
  • Beginning with a protective mechanism
  • RK Meghen at Imphal [28 Nov] #3: Gallery
  • Destination NE @ Vanarasi #2: Gallery
  • Fireflies : Doc Film at Kathmandu Fest
  • Remove State Women Comm Chairperson
  • CAB 2019 : Great Constitutional Blunder
  • The Early Winter's Song :: Poem
  • 'Kumbhakarnas' have 'waked up'!
  • The Killing Fields 2013-19 : News Timeline
  • Against the enactment of CAB : DAMMS
  • Where is the solidarity ?
  • Traffic mess again
  • Mister Manipur 2019 #1 : Gallery
  • Nupi Lan- Women War Of Manipur: Articles
  • Stealthy swearing-in post, cabinet approval
  • Horrors of Kuki Rebellion 1917-1919
  • Relevance of Nehru today #3
  • Thadou Inpi welcomes ILP in Manipur
  • CAB: Protest at Jantar Mantar
  • Centre- yes to ILP; Understanding the crux
  • Extension of ILPS - Too early for celebration
  • Photos from 2012-2019 : Inner Line Permit
  • Miss Kut at Imphal #5: Gallery
  • Demand for Inner Line Permit (ILP) : Articles
  • Brahmacharimayum Mahendra : Silpbhusan
  • My worries in filing stories about Assembly
  • Silver jubilee of Tingkao Ragwang Chapriak
  • My DSLR Journey :: Travelogue
  • Career in CAPF
  • Killing 2 birds, 1 stone : No CAB, Yes ILPS
  • A phone call that overwhelm our CM
  • NTC opposes Pan Naga Hoho post solution
  • Inauguration: Sangai Fest #1: Gallery
  • Induction of NCC Microlite Aircraft : Gallery
  • Is disruption possible in Manipur politics?
  • Sex education: The unspeakable undeniable
  • CAB: Protest at Delhi University
  • KASHISH 2020 : Queer Film Festival
  • The rape circle is complete
  • WC refutes NNC pledging support to FA
  • Communities @ Shirui Lily Fest #1 : Gallery
  • Winter Relief @Tokpaching : Gallery
  • My way only :: Poem
  • Remembering Dr BR Ambedkar #1
  • Winter Relief Service at Arong Khunou
  • Karnataka-Manipur Cultural Festival
  • Workshop on MOOCs at NEHU
  • Beauty essential while traveling in winter
  • Reinstate workers fired in FCI
  • Significance of windows
  • Thanga Ningol to mapam #3 : Gallery
  • Xmas shopping @CCpur [Dec 6] : Gallery
  • Irawat and 1939 Women's War
  • Naga Peace Process :: News Timeline
  • Cannot end AIDS without combating AMR
  • Power of Pranayama #2
  • Jobs @ Birla Emporiums, Khurai
  • Memo to BOSEM, Manipur
  • Appreciation to Kuki Iron Lady
  • Questions over 'instant justice'
  • Optimist perspectives
  • NE bandh call on Dec 10 against CAB
  • Football: Manipur vs Mandalay #2: Gallery
  • Flower festival at Mao : Gallery
  • #iWill :: Poem
  • H Nageshwar : Expedition to Antarctica
  • Relevance of Nehru today #2
  • Climate Change & Agricultural hurdles
  • The Rat on the Run :: Poem
  • Info from Delhi; Reading ILPS idea
  • Confusing the constitution
  • Finding on Yek of Meitei & Hao #1
  • Miss Kut at Imphal #4: Gallery
  • A Girl with Golden Hair :: Poem
  • NEP for Skill India
  • The great cosmic discovery - III
  • Interference by TA & Hills official
  • A one line statement from Amit Shah
  • Insertion of a clause to Peoples' Bill
  • RK Meghen at Imphal [28 Nov] #2: Gallery
  • Midnight drama, hush-hush swearing-in
  • Plight of peasants in the hills #2
  • Jobs @ Kanglei Khoni, Langthabal
  • Drones can be an innovative career
  • Winners @ South Asian Games
  • Winners @ Asian Athletic C'ship
  • Waiting for CBI probe
  • When the savior turns perpetrator
  • Tapta: Jayenta Loukrakpam :: A Profile
  • Destination North East @ Vanarasi : Gallery
  • Winter Book Sales at Manipur University
  • The Vow :: Poem
  • Written assurance is still not tenable
  • Protest against rape of woman vet
  • From 2012 to 2019 no change
  • The 'Trust' factor
  • NSCN (IM) clarifies on 'calendar' issue
  • Centre assures flights betn IMF & Mandalay
  • Sanathong Water Fall, Chandel : Gallery
  • Facts about Naga insurgency #2
  • CC Meet 2019 : Match Fixture
  • Commemoration Kuki Rebellion 1917-1919
  • Moirangthem Sushilkr : Honorary Doctorate
  • Power of Pranayama #1
  • Khumang: 'Science for Society' Report
  • A fresh look at ST demand
  • Wakching Thana Lakpada #1 :: eRang
  • Football: Manipur Vs Mandalay : Gallery
  • December Calendar for Year 2019 : Tools
  • Why not carve out a future in Chakhao ?
  • Relevance of Nehru today #1
  • The great cosmic discovery - II
  • Diversion - the age old shrewd game
  • Lamhui amashung Keishal : Funga
  • Eyek Tamba :: Learn Manipuri script
  • Kut : State level @Imphal #4: Gallery
  • Sangai Festival: Extended till 2nd Dec
  • 133 months left to make U=U (on HIV)
  • Galaxy Roy & my Sainik memories
  • Need to silence the loud mouth
  • CAB issue raise in Zero Hour
  • RK Meghen at Imphal [28 Nov] #1: Gallery
  • Plight of peasants in the hills #1
  • Nawa Loude :: Poem
  • Awarded, outdated currencies & MCS/MPS
  • Social Unrest in N-E Regions
  • Winter care for beautiful hair
  • No harm but a clause needed: The absurdity
  • A blow to survival
  • Leirum- used in Luhongba : Gallery
  • Ningol Chakkouba Shopping #2 : Gallery
  • Road safety in Manipur: need to plug gap
  • AAI steps up effort for gender equality
  • Preparing children before diagnostic test
  • Licypriya Kangujam embarks on 5 Nations
  • One Word of Truth :: Poem
  • Riders in the assurance of Amit Shah
  • GK Pillai's way out and today's Manipur
  • Mera Houchongba @Kangla #5: Gallery
  • Facts on Naga insurgency & its impact #1
  • Binodkumar: public urinal with plastic waste
  • Joining Indian Navy as sailors
  • National Constitution Day observed
  • Condemn incident of molestation in CCpur
  • After a date with Amit Shah
  • Sustaining Evening daily- challenging task
  • Culturals @ Shirui Fest #3: Gallery
  • Banana Festival @ Noney #2 : Gallery
  • Air pollution rise what do common man do
  • Conversation with Prof Rajendra Kshetri
  • 'It is a unique experience to play polo here'
  • The great cosmic discovery - I
  • Make Delhi trip meaningful !
  • Confusing stand; confusing act
  • Manipur Polo International: Opening: Gallery
  • Kut : State level @Imphal #3: Gallery
  • Kalum Kai: House of worship of Zeliangrong
  • Christian virtues
  • Blame it on Farmers for Pollution
  • Title: Square one ? :: Poem
  • Bucket of cold water after a hot shower
  • Radio-tagged Amur falcon flies to Africa
  • Myanmar Air KBZ flight to Imphal: Gallery
  • Alert Rally @ Sagolband : Gallery
  • 50th International Film Festival
  • World Antibiotics Awareness Week (WAAW)
  • CAB : Indians are not foreigners
  • Dissolution of TSA Imphal Branch
  • Anti-corruption crusade at time of CAB
  • Gandhari (Dance Drama) #2 : Gallery
  • Epilogue to Nambul Nostalgia :: Poem
  • Hostile education system in Northeast
  • Stigma and mental illness
  • Paulallungmuan: 12 yr-old at Class X exam
  • 3 from Manipur named Unsung Heroes
  • Raids at Imphal, Aizawl, Gurgaon
  • Make sure that Sangai fest is successful
  • Laonii Festival, Poumai #2 : Gallery
  • Khamba Thoibi Museum #2 : Gallery
  • Enigma of Unique Histories
  • When God's people humble
  • The great cosmic discovery - V
  • TB prevention is no longer a choice..
  • Stakeholders to be consulted: Final pact
  • The unresolved crisis
  • IM leaders camping along India-Myanmar
  • Trekking to Dzukou Valley #3 : Gallery
  • Licypriya- SDG Ambassador Award: Gallery
  • Featured Front Page Photo 2019 #5: Gallery
  • Whither Pangals ?
  • Licypriya Kangujam: SDG Ambassador
  • Blood Donation Camp at Benguluru
  • The Sun on the Western Horizon :: Poem
  • Rejoinder to NDPP [20 November]
  • Regarding resignation of NPF Youth Wing
  • Rider to be exempted from CAB: ILP
  • Truth, sincerity & commitment ...
  • CAB : Total Shutdown - Nov 19 : Gallery
  • CAB : Sit In Protest - Nov 19 : Gallery
  • Dr Sanajaoba (Dr KS Singh): Reminiscence
  • Career option in technical writing
  • What Mindset does Govt of Manipur have ?
  • 12 Members resigned from NPF
  • Where is the special clause in CAB?
  • Please understand CAB; future is at stake
  • CAB protest - Nov 18 : Gallery
  • Children's Day @CM Bungalow : Gallery
  • Why CAB is being opposed in North East
  • Meeteis' paradox
  • A Vision :: Poem
  • NE development: Lean on regional planning
  • Sand War- deadly war against mother Earth
  • From 'ahead of final pact' to CAB
  • Can Meitei, Naga & Kuki jointly resist CAB?
  • Mera Houchongba @Kangla #4: Gallery
  • Ningol Chakouba Fish Fair #2: Gallery
  • Cry of a Dying River : 100 Poems
  • Culturals @ Shirui Fest #2: Gallery
  • Ningol Chakouba @ Pune : Gallery
  • Rani Hingchabi :: Funga Wari
  • Salt brines : Source of Meitei Thum
  • Ema Keithel (Khwairamband) #2: Gallery
  • Thanga Ningol to mapam #2 : Gallery
  • Ningol Chakkouba @ Korea : Gallery
  • Ningol Chakkouba @ Mysore #2 : Gallery
  • Ningol Chakouba & Kut at Korea
  • Ningol Chakkouba by Journalists : Gallery
  • Tolloi, Ukhrul :: 360 Panorama View
  • SPONSORED ADS