RESULTS’ Health Advocacy Assistant, Bruce Warwick, looks at the awful side effects that can come with anti-TB treatment and discusses the urgent need for funding into research and development for new medicines.Â
Last week, on Friday, I came across this article in The Guardian. Written by Dr. Emily Wise who is currently volunteering in Uzbekistan for Médecins Sans Frontières/Doctors Without Borders (MSF).
The article raises a topic virtually impossible to understand unless one has gone through it themselves– that of the side effects of anti-tuberculosis drugs. Not only does it illustrate the turmoil many go through but it also serves as a powerful reminder of the great urgency needed in funding and developing new medicines against drug-resistant TB.
Drugs for ‘standard’ cases of TB are accompanied by often-unbearable side effects. However, it is during the treatment of multidrug-resistant TB (MDR-TB) – a strain of TB that develops if treatment is interrupted or insufficient – that can bring on the most serious of side effects – these include vomiting, diarrhoea, headaches, dizziness, irritability, anxiety and sensitivity to light to name just a few. As is said by Dr. Wise you can also add depression and suicidal thoughts to that list.
Appallingly, she explains that in the past month alone five of her patients have attempted to take their own lives. Not because of any underlying illness but because of a chemical effect resulting from the ingestion of the anti-TB drug cycloserine.
The drug cycloserine has the potential to precipitate depression, psychosis and suicidal thoughts in patients.
It is not just cycloserine that presents a problem. I have also heard stories of patients who cannot bear to take the drug protionamide because of the nausea and headaches it has caused them. A few months ago I interviewed former TB patient, and current TB advocate, Oxana who summed up the intolerable nature of the drugs when telling me:
The only thing I would like to say is that I would never wish that experience on my greatest enemy.
For many this is on top of a whole range of other problems associated with having TB and getting treatment. Jonathan Stillo, a medical anthropologist and someone who has experienced these side effects first hand, explains here that people lose friendships, social circles, acquaintances and ways to support their families when they are infected with TB. His story specifically relates to TB patients in Romania, but nonetheless mirrors what millions of people go through elsewhere in the world when tackling the disease.
While undoubtedly all the more harrowing for the TB patient the side-effects of the drugs nevertheless have an impact on the health workers caring for the patients and also their friends and families. As Dr. Wise says,
As a responsible doctor, I try to maintain a calm air of authority, but I am often keenly aware that I am actively trying to suppress and conceal my own stress. Working in such desperate situations triggers a rollercoaster of emotions and, when working in a region where only handful of us hold internationally recognised medical qualifications, the feeling of responsibility is a heavy burden.
I reiterate the final words of The Guardian article when I say that we urgently need the pharmaceutical industry and the international community to wake up and put this disease on the agenda.
We must also remember how difficult it is for all involved in treatment, whether it be the patient themselves or their families, friends, doctors or nurses. Any progress made in fighting the disease is threatened and millions will continue to die if research and development into new treatments are not fully funded.
I recommend reading The Guardian article which can be accessed here.
You can also read Emily Wise’s blog on her experiences volunteering for MSF here.