Via The Lancet Respiratory Medicine, a fascinating article: Landmark legal ruling sees Indian girl prescribed bedaquiline for XDR-TB. Excerpt:
Tuberculosis experts and human rights advocates have hailed a landmark ruling by the high court in New Delhi, India, which has forced authorities into providing bedaquiline treatment to an 18-year-old girl with extensively drug-resistant tuberculosis (XDR-TB). The girl, from Patna, eastern India, had been refused the treatment before asking her father to launch the legal action on her behalf.
Despite its expedited approval process and safety concerns, there are high hopes for bedaquiline, the first new tuberculosis drug to be approved in 50 years. It is seen as a vital new tool in the battle against multidrug-resistant tuberculosis and XDR-TB. However, in some countries, such as India, strict protocols are in force that limit access to bedaquiline to just five states, with estimates that less than 200 patients have received the drug out of an estimated 79 000 patients with drug-resistant forms of tuberculosis.
The Indian Government, via its Health Ministry, had been insisting before this case that this tight control is essential to prevent resistance from developing to bedaquiline. Yet human rights campaigners and medical experts have argued that the protocol will do little to limit resistance and while access is denied, many of India's sickest patients will transmit drug-resistant forms of tuberculosis to others before facing death themselves.
The girl who launched the legal action only learned about bedaquiline's existence in October, 2016, during a chest examination in Mumbai—5 years after being diagnosed with tuberculosis. Because her doctor could not prescribe the drug privately, he recommended she request it from the National Institute of Tuberculosis and Respiratory Diseases in New Delhi, but she was refused because she is not a resident of that area.