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
  • Chayom Thupki (Meetei Philosophy) #12
  • Shirui Lily Fest - Inauguration : Gallery
  • 'Unethical act of few Orgs of a community'
  • In defence of ancestral land and freedom
  • Not just twin but triple demands of NSCN-IM
  • Govt College Teachers' Assn : GBM
  • The Killing Fields 2013-19 : News Timeline
  • Pressing need for sanity to prevail
  • Forgotten pledge - a reminder
  • 123rd Lamyanba Irabot #3 : Gallery
  • May all the roads lead to Ukhrul ..
  • AMAND Cultural @Pune #2 : Gallery
  • Naga Flag & Constitution is our Identity
  • Global Handwashing Day
  • Gwangju Prize for Human Rights: Nominate
  • German program for women entrepreneurs
  • Raising the integration bogey, again
  • October 15 and the GoI
  • NTC calls for solution within scheduled time
  • Naga peace talks deadlocked
  • Pot Lannaba : Houchongba #1: Gallery
  • IM & Govt against freedom fighters
  • Wijaidin Pamai @Intl Fashion Week Goa
  • SheChef Season 2, Shirui Lily Festival 2019
  • Crazy for the hole :: Poem
  • Intl Classical Manipuri Dance Festival
  • Putting a check on single use plastic
  • Harvesting the green gold
  • Mera Houchongba @Kangla #1: Gallery
  • Mera Houchongba festival
  • Intl Day for Disaster Risk Reduction
  • Understanding JAM for bright career
  • For you, I gave up everything : Poem
  • Paranoia of Beauty: A Corporate Brainwash
  • Naga Peace Process :: News Timeline
  • Opening NE to outside world: Challenges ..
  • Contested Identity Along Myanmar Border
  • NNPGs mandated for solution: Isak
  • Wont walk path of capitulated peace: IM
  • 3-month deadline ..unacceptable: Hoho
  • Manipur Street in Manchester & Shirui Lily
  • A glimpse of Shirui Flower : Gallery
  • World within a World
  • Face of RaDiant Group
  • For the Common People :: Poem
  • Heart Camp at Senapati District Hospital
  • NDPP is 'verba non facta' : NPF
  • Swindling of Public Money
  • Bor khoiramba @Hiyangthang #2 : Gallery
  • Lansinganglu, Ahinglang : eMing
  • World Tourism Day @Noney #3 : Gallery
  • World Mental Health Awareness Week 2019
  • Manipur lost legacy- Merger Agreement #2
  • My aquamarine :: Poem
  • Rice for beauty
  • Stand off over flag and constitution
  • Suicide - Western docs, Psychologists...
  • Naga wont accept alien doc. as constitution
  • Manipuri Calendar 2020 :: Download
  • AMAND Cultural @Pune #1 : Gallery
  • Inner Line Permit (ILP) Demand : Timeline
  • NE Message of Cleaninness at Delhi
  • Research Support Officer @ Amethyst
  • 8th AGM/Annual Cultural of AMAND, Pune
  • Peace & conflicts studies as a career
  • College student leaders learn leadership
  • Reaffirming stand of 2016 unity
  • Mr. Chief Minister, clean the dirt...
  • Nongdol Leima @ JNMDA #2 : Gallery
  • Haloi Taret: Dangerous Beauty....
  • Difficult days ahead for Muivah
  • Manipur from Independence to Merger #3
  • World Mental Health Day, 2019
  • Traditional DJ
  • Cry of a Dying River - 96 :: Poem
  • ..district to State level : Shirui Lily Festival
  • Something is still not right
  • Chothe Achui Lin festival #2
  • Heritage Park @Sangai Fest #3: Gallery
  • Are we being bullied with same fake news?
  • Hard facts about the betrail
  • World Animal Day 2019
  • Academic Entrepreneurship at MU #2
  • Nagas of Nagaland : Drawing the divide
  • ... Manipur needs strategic change
  • World Tourism Day @Noney #2 : Gallery
  • ST status is to save indigenous community
  • Sangai festival and tourism multiplier
  • Governance, Gender & Environment :: Book
  • Now Your Hair :: Poem
  • Neiphiu Rio's myopic belief on ILP : NPF
  • Probe into maladministration of hospital
  • Taking high moral stand: Begone moral cop
  • Bor khoiramba @Hiyangthang #1 : Gallery
  • Manipur lost legacy- Merger Agreement #1
  • Sikkim Dance @Sangai Fest: Gallery
  • World Habitat Day: A celebration for home
  • For Your Eyes Only :: Poem
  • No School bag day in Manipur
  • Making ban on single use plastic effective
  • New CAB clause to protect NE : HM
  • NNPGs ready to conclude talks: Kitovi
  • 123rd Lamyanba Irabot #2 : Gallery
  • Ngangom Chaoba : Natyabhusan
  • Ganja economics, Jai Bholenath !
  • Soul Sister :: Poem
  • Leap of faith on wings of Prayer
  • Counselling: Children in Conflict with Law
  • Caution for the cocksure
  • CAB Protest @Khwairamband : Gallery
  • Manipuri Women & Crime Against them
  • Toward exploring a better future for youth
  • I happily cry :: Poem
  • NE Students' Culturals at Pondicherry
  • Beauty benefits of banana
  • Heart Camp at District Hospital, Chandel
  • Contained but final word yet to be said
  • Smart idea, bumbling idealists
  • Chingda Satpi Engellei #2 :: eRang
  • Facts & Opinions: Integration of Naga Area
  • Licypriya : Earth Day Network 'Rising Star'
  • Cry of a Dying River - 95 :: Poem
  • Khangminashi - V at Ibotonsana Hr Sec
  • Academic Entrepreneurship at MU #1
  • Vote BJP but protest: CAB Indecisive stand
  • Significance of Manipuri proverbs
  • Hathei Phanit (Chilli) #2: Gallery
  • Naga insurgency & peace condition #2
  • World River Day, 2019
  • Half Brother :: Poem
  • Youth Essay Contest: May 18 Memorial
  • Michelle Salam : Top Ten Cake Masters
  • Internal tussle within the Government
  • The humility of MK Gandhi & Manipur
  • Bhagyachandra Death Anniv @WB : Gallery
  • Why dont Manipur forget Merger Agreement
  • Let us celebrate Non Violence Day
  • Looking Forward to a Sexy Evening : Poem
  • Observance of Senior Citizen's Day
  • Turmeric in beauty care
  • Artists for NH7 Weekender, Meghalaya
  • Parking madness at commercial centres
  • Demise of a dream
  • 123rd Lamyanba Irabot #1 : Gallery
  • International Day Of Older Persons, 1 Oct
  • Licypriya : India Peace Prize : Gallery
  • Irabot the poet of the working class
  • October Calendar for Year 2019 : Tools
  • Licypriya Kangujam : India Peace Prize 2019
  • ST status demand for Meiteis widening rift
  • Certificate Course on Neuropsychology
  • Lining up stand against CAB
  • Remembering Lamyanba & his politics
  • Irabot Day & the practice of volunteerism
  • Lamyanba Hijam Irawat :: Read articles
  • Around India in 60 days
  • Nungleiband Massacre: Diary of Editor
  • Judo: Rishikanta, Roshibina, Kalpana
  • Heart of an empowering woman : Poem
  • Imphal Peace Museum: Best Design Award
  • Engaging with the young minds
  • Lai Khutsangbi & female power
  • Naga liberty or forced disintegration..
  • Irabot's letter to Assembly: 18 Oct 1948
  • Monika Ingudam: Natl Youth Icon Award
  • Heart Camp at District Hospital, Ukhrul
  • Swacchata Hi Seva at Lakoipat
  • Let 'tree' that was cut, be the last
  • World Tourism Day @Noney #1 : Gallery
  • Where All The Flowers Gone? #2: Gallery
  • The resurgence of Hijam Irabot
  • Naga insurgency & peace condition #1
  • World Heart Day 2019
  • Judo: L Sushila; M Bidyashori, T Inunganbi
  • Counselling: Children in Conflict with Law
  • Looking to increase revenue collection
  • Adapting with the changing time
  • Inamma - Film Scenes #1 :: eRang
  • Heritage Park @Sangai Fest #2: Gallery
  • Cry of a Dying River - 94 :: Poem
  • Reject false solutions to climate crisis
  • Career in Mass Communication
  • Ideals of Lamyanba Irawat
  • Laurels for Th Brinda, Ng Touthang
  • Performances to watch at NH7 Weekender
  • Protest in NE against CAB starting Oct 3
  • Bamboo bus shelter model developed
  • Noney to host World Tourism Day
  • Drought and the drainage issues
  • Marangwon @Kangkhui Khullen: Gallery
  • The flavor of Utsav Tarpon
  • Urgent Need to Reconsider Naga History
  • A woman :: Poem
  • Human Papilloma Virus & women's health
  • Meeting the Enemy at Nathu La
  • 'Outburst' of Thuingaleng Muivah
  • Concerns for media persons
  • Ibudhou Thangjing Haraoba #5 : Gallery
  • Licypriya Climate March @Angola :Gallery
  • Featured Front Page Photo 2019 #4: Gallery
  • Licypriya Climate March at Luanda :: Report
  • Workshop on Science Writing
  • Nurabi, nominated at Rio WebFest
  • Manipur retain Senior Women's NFC title
  • Robert Naorem : Best Intl Fashion Designer
  • Process of updating electoral roll
  • Ban on plastic use
  • Kartal Cholom @ Sangai Fest : Gallery
  • Reflection on Tolstoy, Irawat & Dr. Kamal
  • Local solution, local action for #GlobalGoals
  • In You I Find My Sunset :: Poem
  • ... denying rights in actual practice
  • Landslide: Are Mitigation measures effective
  • Emotional Intelligence: Yardstick for life skill
  • eNabling North East Award 2019
  • The debate over legalising ganja
  • The new MVA; how serious is the govt ?
  • Chothe Achui Lin festival #1
  • Lady E-Rickshaw driver inspires women..
  • M Shanker: Indian Achievers Award 2019
  • Softly Coo the Wild Pigeons :: Poem
  • Discussion on Manipur Merger Agreement
  • Irabot, one & only leader of oppressed mass
  • Start-up Manipur as a potential launch pad
  • Culture Students Foundation Day : Gallery
  • Eyek Tamba :: Learn Manipuri script
  • Territorial Integration, Flag or Constitution
  • Book published on Irabot Day: Download
  • In love with the night :: Poem
  • Maverick mind of Ram - Dedicated to Bar
  • Smoking- silent killer for your backbone
  • Revisiting Sept. 21 (1948 & 1949)
  • Where All The Flowers Gone? #1: Gallery
  • BCIM Corridor & China New Transportation
  • Alzheimer's Awareness Month
  • Cry of a Dying River - 93 :: Poem
  • Rally & Youth's Voice on Climate Change
  • Guwahati to Bangkok : Direct Flight
  • Stringent traffic rules in place
  • Time for immediate solution to climate crisis
  • Traditional Dress of Hmar : Gallery
  • Licypriya @UNESCO Forum, Angola: Gallery
  • 46th AMWJU Foundation Day : Gallery
  • Heikru Hidongba #2 : Gallery
  • 48th Foundation Day of RIMS : Gallery
  • Chaklam Khongchat Numit #4: Gallery
  • Mukna - indigenous game : Gallery
  • Babysana's last rites performed: Gallery
  • Tolloi, Ukhrul :: 360 Panorama View
  • SPONSORED ADS