 U.S. pharma major Johnson & Johnson will not enforce its patent on the TB Doug by Dacqueline. How did the company come to make this announcement? And what does it mean for millions of TB patients around the world, but particularly in low and middle-income countries? The U.S. House of Representatives is looking for a new speaker after Kevin McCarthy was voted out. Why did this happen? And who might replace him? We find out why Guatemalans, particularly indigenous communities, are on an indefinite national strike demanding the removal of the country's attorney general. Salam, you're watching Daily Debrief coming to you from a different setting today, because the Delhi police's special cell raided the People's Dispatch and Newsclick offices and have sealed the office as well as the studio from which we normally operate, but we're using the internet to continue our coverage on Daily Debrief and on People'sDispatch.org. If you haven't already, this is a good time to like and subscribe to our YouTube channels and of course also share this video with your friends. Our first story is a big one. U.S.-based pharma major Johnson & Johnson, as I was saying a little while ago, has announced that it will not enforce its patents on Serturo, which is its brand name, for the salt bedakwiling, which is a path-breaking tuberculosis medicine, the first drug of its kind to be approved for wide usage in about four decades. It offers the opportunity to sort of increase access to TV medication for millions of patients around the world. And this will apply in 134 countries, low and middle-income countries. It's the result of sustained campaigns, sustained pressures from multiple groups and also comes soon after the Indian Patents Office rejected an application for a second patent on the drug by Johnson & Johnson. Joining us with all the details is Jyotsana Singh, health journalist Jyotsana Singh, who has been on the show frequently. Jyotsana, good to have you on Daily DB, as always. Tell us first how this came about, Jyotsana, before we talk about the massive impact that it's likely to have on the treatment of TB. So firstly, I think congratulations to you all for actually doing this Daily DB despite all the problems that have been imposed by the government and the Delhi Police as a special cell. So this is great and thanks for calling me. So yes, it is a really big development in the field of medicine and health sector. After decades, we have received something we have been able to break patent barriers which will give access to a lot of patients across the world. Before this, it happened in the early 2000s when the HIV medicines actually, there was a fight and the generic versions of those medicines came about. So it's a big deal. But this is no charity by the company. It is not that their hearts have changed. It has come, as you said, after a lot of struggle, a lot of struggle. I remember I started writing on this topic and started working in 2016. Since then, so many organizations and individuals have fought and the TB survivors and the TB patients have fought since 2016, at least or maybe before that, to really have this medicine cheap and accessible and available to everyone who needs it. So that is the thing. So just to ensure to tell you what the issue was, Johnson & Johnson is the company which has, which is the original company for this medicine Vidakulin, which is a very, very important medicine for drug-resistant TB. And before that, if you do not have this medicine in your treatment regimen, then you are dependent on certain other medications which have terrible side effects, something like an injectable called canamycin, which leads to permanent hearing loss. There are medicines which give you psychosis, make you suicidal. So we need it to replace those medicines and this particular medicine has a very good safety profile. But Johnson & Johnson held the patent over the medicine. So normally, something what is called primary patent, that is a basic patent on a medicine, it lasts for 20 years. So for 20 years, a company has complete monopoly over the medicine, they only manufacture it, they only sell it. After that, what kicks in is called secondary patent, where just by tweaking the medicine very less, like very little tweaks the company can do and extend this patent for many more years. In this case, it would have been for five years. So they wanted five more years after having after having had the monopoly for 20 years, they wanted more. And that is what the secondary patent which was, they applied for across the world despite the hue and cry by so many people, including patients affected by TP. So they did that. But then in the past few months, quite a few things happened. So as I said that people have been fighting since 2016, which has forced the governments also to take a stand finally on these issues. So the Indian Patent Office rejected the secondary patent application of this medicine. And that patent opposition was actually filed by two very courageous women who both survived extreme drug resistant TB somehow, but have faced terrible side effects. They went to the court saying that we supported others should not. So that was a big victory. Then after this, the Ukrainian and the Belarus governments, they actually asked Johnson and Johnson to drop this secondary patent in their countries. And after that, the South African governments competition commission that is their body, it has actually launched an investigation for NJNJ on JNJ on the pricing of the medicine and on asking for secondary patent. So there was a lot of pressure on JNJ finally that came up. And as in one of the shows, John Green, the famous American writer and YouTuber, he said that, you know, we have had these medicines for a long time. You just have to give it to the patients and they will be saved if they still die. It is because of the system. It is because of something else. And for the drug resistant TB patients, for a lot of them, it was this medicine which was one of the medicines, which was the reason. So yes, so it is good that the Johnson and Johnson has said it will not have secondary patents. Already, there are three companies from India who have the capacity to produce these medicines and it will happen. And just very shortly to give you a few numbers. So we have something around 1.6 million DRTB patients every year in the world. And if you look at the data, not more than 10 to 15% of them have actually got this medicine, though it should have been given to all of them. So that is where we are. More companies also mean more production, not only the price drop, which is very important, but also more competition. In terms of price, we talked about South Africa. So I am just giving an example. In South Africa, bit alkaline per patient costs something like 285. Let me try to interrupt you. I know it is my internet, but we are having a bit of trouble with your audio. Could you just take us through the last bit that you said once more, please? So if we talk about the pricing in that sense, how cost-effective bit alkaline is. So in South Africa, it costs something like US dollars 285 per patient. And it is only one of the medicines out of a cocktail of 4 to 6, which are to be given to the patient. So if we add the cost, it becomes a lot more than this. So now it will be cheaper. And Indian generics, when they start to produce, we will have more courses being produced. We will have cheaper courses for patients to grab. And so it will be good. And we should really thank the activists and the TB survivors who have continued to fight for this. Right. So by as much as two-thirds, perhaps the cost of the overall medication can be reduced, Josna, if I'm not wrong. Very quickly, because we're almost out of time. Very quickly, if you can tell us what happens next, this is by no means, of course, the end in the struggle to get TB medicines to patients. Yes. So we still have many more things where the prices should come down. One major thing is that the test for drug-resistant TB, that is by this company called Seafit, which is one of the subsidiaries of Dana, it costs a lot. They were charging 10 US dollars per test. They brought down the price a few weeks ago to eight dollars. But actually, even if they get reasonable profit, they should not be charging more than five US dollars for that. So that has to still come down. And the government and the company has to take a stand. Then there is another medicine called Delaminate, which is by a Japanese company called Otsuka. It is actually costlier than Bedakulin. And that is one medicine which is very safe for children. And when I said that you, what are the problems with older medicines? So there is this injection which you have to take daily if you do not have Delaminate or Bedakulin. And there are children who are given these injections for six months every day once a day. So to stop all that to happen, Delaminate is a very important medicine. But still there is no commitment from Otsuka to drop the price or to give up the patent. That has to happen. Pritomanid is a third drug, which is also, there are patent claims on it across the world. That, again, has to be fought and the companies should be asked to drop their patents and stop the IP barrier for all of this. I think if all of this happens, then we can actually think of eliminating TB and not before that. All right. Thanks very much, Joseph, for kicking off the show with that actually really important and historic in many ways story and hopefully it continues. And we'll have you back very soon, I'm sure. We're moving on now to the US where the Speaker of the House of Representatives has been voted out in what was a right-wing revolt within the Republican Party. Anish is with us and will tell us hopefully what this means because this is one of the most important political jobs in the United States. Anish, good to have you on debrief. Yes. Yeah. So just take us through the process. Anish, it seems to be the culmination of a thing within the Republican Party and McCarthy that's been ongoing for quite some time. Yes. I mean, we did the election itself, McCarthy's election and how it took about about 15 rounds of election for him to actually secure the seat. And it came pretty much with this one major concession, which was that a single member in the House can actually initiate removal process for the Speaker, a no-confidence process that we would call in our parliamentary system. And it clearly has come to bite him right now. And this is kind of historic in many ways because it's the first time that a Speaker has been removed while the legislature, the US Congress, was in session. And that pretty much brings the entire process of federal legislation into completely uncharted territory because they never had the system of having to deal with a temporary Speaker or, I mean, even the Constitution and the legal system is pretty much very vague on how this legal, sorry, this temporary Speaker is going to function. But obviously, the fight or the infighting that we see within the Republican camp is pretty much coming from a very interesting set of issues. First of all, we see that this was a very small minority that actually brought about this vote barely about eight people from the Republican Party who voted in favor of removing McCarthy. The rest of the votes were pretty much Democrats. So the small group of people belong to, as we all know, from the freedom caucus within the Republican Party, which is basically the very far right, usually known as the most pro-Trump section within the Republican Party. And they are the ones who have been calling for a set of cuts, major cuts in government funding and also spending on the Ukraine war. And it's quite interesting, the kind of issues that have come up because of this entire process. And it pretty much shows the kind of divide that even the most rapid right within the United States is going through, the kind of confusion it is going through within the elite, the ruling class and the US establishment itself. So Anish, given the importance of the job of the Speaker and the kind of level of seniority that the Speaker of the House occupies, what happens next? And who is likely to replace McCarthy? It's a very difficult thing to say who will be next because pretty much there's nobody right now who has a very clear support from across the section. What we're seeing is a very clear divide that is not very easily reconcilable within the Republican Party. And obviously the Democrats are having a field time of their own. But if things do not fall in place by say early November, even they might be in panic because that is pretty much the deadline for the temporary spending bill that McCarthy passed, which was the reason why he was kicked out of the office for gaining democratic support. And so if they do not have Speaker by then, they might not be able to pass a spending bill and which brings the government into a shutdown, a partial shutdown. But most importantly, first ever default in the over $31 trillion of US national debt. And so that is a major problem that like it's a ticking time bomb right now that the entire House has been brought into. And it pretty much is a situation where the Congress has been kept hostage by a small group of right-wingers who are not, let's remember, who are not that radically different from the other conservative counterparts within the Republican Party or even many of the establishment Democrats in the US Congress because considering many of their policies itself. But it's just that how averse to concessions that this small group are is what concerns the US ruling class. And this pretty much exposes a whole lot of laws within the US congressional, presidential system, the manner in which things function. But also it exposes fault lines that was always simmering within the ruling classes. And that pretty much is a situation. So you have obviously Jim Jordan coming in, who is the leader of the Freedom Caucus. But then there's also Skelly, who is the House Majority Leader. If you look at them, they're not that radically different. Both of them are very vehement Trump supporters and pretty much supported most of his policies while in presidency. So they're not that very different from each other. So we do not know what kind of change we can expect in the coming days or if there is going to be a timely change for the speaker's position. Alright, thanks very much Anish. And I'm sure you'll keep tracking that for us. Next up in our final story for the day, Guatemalans have taken to the streets and are on a national strike, primarily Guatemala's indigenous communities. They're on an indefinite national strike that began on Monday. The strike was called last week and it's been called in protest to demand the resignation of Attorney General Consuelo Pojas for her attempts to intervene in the country's election results this year. Zoe Alexandra has been tracking that story and let's go over to her now to find out what's going on. Zoe, good to have you on debrief. Hope you're well. Tell us what's happening in Guatemala at the moment and since it's been on since Monday, what sort of progress has the strike made? Well, it's a super crucial story and as you said, we've been tracking it at People's Dispatch in essentially this repression against the semia party of the presidential elect Bernardo Arrivalo, which is essentially that these protests are against the actions that are being taken by the Attorney General against this president elect and his party and this all started in the first round of the presidential elections in the country where Bernardo Arrivalo, who is from a center left anti-corruption party, came in first in the first round and this was very shocking that he would be going to the second round of the elections. Many of the establishment politicians thought that they had it in the bag. They've been able to rule over Guatemala for years and all of the privileges that that comes with and so as soon as they saw that someone like Bernardo Arrivalo, who consistently speaks out against corruption, who has really allied himself with the movements in the country who has tried to take a stand against establishment politicians, when they saw his rise they said, okay, we need to use all of the instruments that are disposable at our disposal to act and so starting then the prosecutor, the attorney general began a campaign of criminalization against his party suspending the legal representative of the party attempting to make the party kind of inexistent and constitutional saying that it doesn't have legal status, even actions taken against Arrivalo himself going into the second round of the elections. I think the legal status of his parties, Moimento Semi, it didn't even exist, but again, he still went to the elections and won the second round of the elections against former First Lady Sandra Torres. And again, one of the first things he said is that he's going to defend his presidency and he's going to defend the votes of all of the people in Guatemala who voted for him and that he wouldn't tolerate attempts by the right wing to basically invalidate this election. And since then, since his victory, these attacks against him have increased and it's been interesting because as you said, the protesters now are demanding the respect of the electoral results and also the resignation of the prosecutor because it's essentially been sort of this conflict and this dispute between different, not different branches of power, but different institutions within kind of the legal system. So we see on one hand, the Supreme Electoral Court is validating their results and saying that yes, indeed, Moimento Semi can exist. It is a party. They won the elections. These are the results. And then we have another court saying that no, these charges have to be carried out against him and that, so it's been this kind of back and forth. This week, for example, a bunch of lawyers brought a letter to the constitutional court and asking them to reverse these moves that the courts have taken against the party Moimento Semiya. Currently, Arevalo is in the United States meeting with all sorts of different representatives to ask for their support, to say that he won the elections fair and square and that democracy has to be respected. What's interesting in this case is that there's sort of been unanimous international consensus in saying that Arevalo did indeed win these elections and that all of these attempts, for example, by Sandra Torres to not even respect these electoral results are undermining democracy. We've seen state department officials say this. We've seen officials from Europe say this. So there's kind of complete international consensus that what's happening now does constitute what the US would say is an attack on democracy, maybe undermining democracy, and what people in Guatemala are saying is a pending coup. And so that's why we've seen people on the streets saying these attacks continue. They've consistently protested and now they're actually going to this national strike to say no more. We demand that our votes be respected. We demand that these legal bodies do not be used in this kind of law fair scheme to invalidate their votes to attack the president-elect. Zoe, how are things likely to proceed over the next few days? Well, as I said, because there is this sort of international consensus saying that Arevalo did in fact win the elections, the Supreme Electoral Court, which I nicked out to mention, but has suffered several different raids actually. The authorities have raided the Electoral Court taking material, etc. And so I think that we are going to see that this situation will continue to escalate, especially as people march towards the capital city. Protests are expected to intensify. When Arevalo returns from the United States, I'm sure that he's having important meetings with legislators, with different think tanks, etc., to kind of get this support. But it seems unlikely and it seems difficult that the right wing will actually be able to sustain this attack on him and that in fact he will not be, it seems likely that the transition of power will continue, that he will be sworn in as president. But I think what's crucial is, and that we've, a lesson that has been learned, I think by progressive rulers in Latin America over the past several years, is that it is so crucial to maintain the pressure on the streets because the right wing will use all of the tools at their disposal. If they've been in power, they've definitely made maneuvers to occupy the courts, to occupy all possible spaces of power and that even if the executive is occupied by progressive, they have all these other tools at their disposal which they will use. And so I think that the streets which are historically of the people in progressive movements and those who want change and fight for change have to be, I think are recognized as an important tool in order to kind of maintain and consolidate power and show that the people are on the side of democracy and of having their votes respected and that if this doesn't happen, there will be a response by on the streets. On the streets. And I think that's a great note actually to wrap up this episode of Daily Reviews. Thanks very much Zoe as always for being on the show and of course for the work that you do. We'll be back with another episode hopefully same time, same place tomorrow. But again, take this opportunity to ask you once more to support us and the work that we do that people like reporters like Zoe do by subscribing to the channel of course. You can also head to our website peoplesdispatch.org for details on these stories and all of the other work we do. Thanks very much for watching. Stay safe.