Denying access to bedaqualine in India costs lives

As physicians managing the so-called Patna patient—an 18-year-old woman who took the Indian government to court after being denied access to bedaqualine—we commend Amber Kunkel and colleagues on their forthright article.¹ The woman's case is emblematic of the desperation of the many patients with advanced drug resistance and with few therapeutic options that we encounter in our clinic. India's National Tuberculosis Program's (RNTCP) insistence on reserving bedaqualine for patients who have at least three susceptible drugs in the background regimen,² denies this drug to the very patients who would most benefit from it, especially since it doubles the chance of a cure.³ It worries us that such patients, denied access to a life-saving drug, are compelled to move the judiciary to access it. The theoretical fear of protecting a drug has sadly taken precedence over protecting lives.