To Save Her Husband's Life, A Woman Fights For Access To TB Drugs

Mar 19, 2014
Originally published on March 19, 2014 6:13 pm

One year ago Pavel Rucsineanu was running out of options.

Drug-resistant tuberculosis was ravaging his lungs. And the disease had evolved into an incurable form, doctors said.

It's like an "infectious cancer," Dr. Tetru Alexandriuc said at the time. "We have no other medicines" to treat Pavel, the doctor added. Although he wouldn't say it, the doctor expected TB would kill Pavel.

But Pavel's wife, Oxana, had other ideas.

Oxana once had drug-resistant TB, too. She and Pavel fell in love back in 2008 when they were both patients at a TB hospital in Balti, Moldova. The couple had their first child a few years ago.

Oxana had managed to get herself cured of TB. Then she set out to help her husband. Her strategy: Get Pavel some of the new medicines that she'd heard could attack even the most deadly strains of the bacterium.

In 2012, the U.S. Food and Drug Administration approved the first new TB medicine in 40 years. The drug, called bedaquiline, was developed specifically for treating drug-resistant tuberculosis. But Oxana couldn't get the drug imported to Moldova.

"We wrote a lot of letters to the government," she says. "And the official answer was that there is no legal framework to bring a medical product that is not yet authorized in our country."

So Oxana went after another drug: an antibiotic, called linezolid, which the European Medicines Agency had recently approved for use against TB.

Getting this drug also proved to be a huge challenge. Moldova hadn't yet approved linezolid for use. And the medication was prohibitively expensive.

Pfizer has linezolid patented under the brand name Zyvox. And a one-month supply costs more than $4,000 here in the U.S.

But Oxana was still not deterred. She contacted the nonprofit Treatment Action Group in New York and managed to get a six-month supply of linezolid for Pavel.

"From the time you saw him [a year ago], he's gained 8 kilos [17.6 pounds]," Oxana says. "He's feeling much better. ... He's saying he's cured already. But we know that we have some time in front of us with this TB. We have to follow the treatment to the end. But his results [so far] give us big power to move on."

The treatment with linezolid, however, is no walk in the park. Oxana hasn't yet managed to secure enough of the drug for a full course of treatment, which takes 18 months. And the drug comes with serious side effects. The most common is peripheral neuropathy, a form of nerve damage.

"It is difficult, but not more difficult than other drug-resistant [TB] therapy," Oxana says. "All the drug-resistant therapies are difficult. It took about a month and a half for him to get used to the [side] effects."

Linezolid also has to be taken with a battery of other medicines under the direction of Pavel's doctors. "It's more than 20 pills per day," Oxana says. "Yeah, more than 20 pills per day."

But finally, after years of treatment for tuberculosis, Pavel's health is improving. He's no longer infectious, no longer coughing the potentially lethal bacteria into the air.

And the young father is finally able to move out of the TB hospital and into a small apartment with Oxana and their son.

"Thank God, and thank a lot of people who did a lot for Pavel and my family," Oxana says. "He's right good now. And we are very happy about it."

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