Can Shorter Regimens Eliminate Drug-Resistant Tuberculosis?

The World Health Organization (WHO) has taken a significant stride in the battle against Tuberculosis (TB) by introducing shorter drug regimens, aiming to curb a disease that claims countless lives globally. This innovative approach addresses the urgent need for more efficient treatments, especially in regions where TB's toll is highest. With traditional therapies often posing risks to liver health, these shortened regimens offer hope, minimising such concerns while enhancing treatment adherence.

- Ayesha Siddiqui

Despite countries making bold commitments to end TB by 2030, in the Sustainable Development Goals (SDGs), the WHO End TB Strategy and the 2018 political declaration on the fight against TB, the epidemic shows no sign of slowing down. The deadly disease claimed 1.3 million lives in 2022. Drug-resistant TB is a growing threat - about 410,000 people had multidrug-resistant TB infections in 2022. In response to this pressing crisis, the WHO has been exploring various strategies to combat this deadly disease. Among these efforts is the development of shorter drug regimens, aiming to improve treatment outcomes and reduce the burden on patients.

Pretomanid and the Bedaquiline, Pretomanid, and Linezolid (BPaL) regimen, developed by the nonprofit TB Alliance, have transformed the treatment for drug-resistant TB and move us closer to achieving these goals, especially as they relate to the types of TB cases that have traditionally been most difficult and resource-intensive to treat.

Interim operational research results from 5 Central and Southeast Asian countries indicate that the BPaL regimen achieved a remarkable 94.5% cure rate in regions burdened by drugresistant TB (DR-TB). Operational research in these countries was part of the LIFT-TB programme, which provided funding, resources, technical assistance, and wide- ranging expertise from multiple partners for 7 countries with high burdens of DRTB (Indonesia, Kyrgyzstan, Myanmar, Philippines, Ukraine, Uzbekistan, and Vietnam) to advance the implementation and rollout of the BPaL regimen. India is also likely to roll out the new regimen soon.