India to roll out new treatment regimen for drug-resistant TB

• India is getting ready to roll out BPaL (bedaquiline, pretomanid, and linezolid) regimen

Highlights:

• This BPaL regimen for all multi/extensively drug-resistant tuberculosis patients and the training for this new exercise is scheduled to begin this month.
• This is a significant move in the country’s battle against M/XDR-TB with the new regime indicating good results in countries including Pakistan, South Africa, Ukraine, etc.
• The move should improve treatment outcomes and help thousands of patients
• Dr. Swaminathan said in her post: “India is getting ready to roll out BPaL regimen for all
• A nucleic acid amplification test, or NAAT, for tuberculosis (TB) is a molecular test used to detect the DNA (deoxyribonucleic acid) of Mycobacterium tuberculosis complex (MTBC) in a sputum or other respiratory sample.
• After the availability of generic bedaquiline cost to TB programmes has fallen – (BPaLM price is US$426 (US$130 bedaquiline, US$238 pretomanid, US$31 linezolid and US$27 moxifloxacin).
• This is a momentous day for people with drug-resistant tuberculosis, because India will finally replace many of the longer, arduous and less-effective treatments by offering better, safer and shorter BPaLM treatment that is much more likely to cure this deadly disease.
• The next step is to also introduce delamanid-based short oral regimens for children and as an alternative for people who cannot tolerate bedaquiline or linezolid.
• From a treatment duration range of 18 to 24 months, BPaL brings down treatment time to around six months.
• Furthermore, the older all-oral-drug-regimen included nearly 14 different anti-TB drugs for a patient to take every day.
• Currently, India has a 56% treatment success rate for MDR/RR-TB cases, and 48% for XDR-TB cases, attributable to long and toxic drug regimens.
• In fact, historically, treatment of such forms of TB anywhere would take 18 months or longer, with a reported global success rate of 52% in the past.
• In its Global TB Report 2023, WHO said India has made tremendous progress in improving case detection and reversed the impact of COVID-19 on the TB programme.
• The treatment coverage has improved to 80% of the estimated TB cases, an increase of 19% over the previous year.
• It added that the estimated number of drug-resistant TB in India has reduced by 21% from 1.4 lakh in 2015 to 1.1 lakh in 2022.

Prelims Takeaway

• BPaL
• M/XDR-TB