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India to Roll Out New Treatment Regimen for Drug-Resistant TB

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India to Roll Out New Treatment Regimen for Drug-Resistant TB

Context:

India is set to introduce the BPaL (bedaquiline, pretomanid, and linezolid) regimen for all multi/extensively drug-resistant tuberculosis patients, with training for this initiative starting this month.

 

More on News:

  • This is a significant step in India’s fight against multi/extensively drug-resistant tuberculosis (M/XDR-TB)
  • The BPaL regimen has shown promising results in countries like Pakistan, South Africa, and Ukraine.

 

Key Highlights:

  • Nucleic Acid Amplification Test (NAAT): NAAT is a molecular test that detects the DNA of Mycobacterium tuberculosis complex (MTBC) in respiratory samples.
  • The BPaL regimen is priced at US$426 (US$130 for bedaquiline, US$238 for pretomanid, US$31 for linezolid, and US$27 for moxifloxacin). 
  • This regimen is expected to replace longer and less effective treatments with a more effective, safer, and shorter treatment course.
  •  India’s treatment success rates are currently 56% for MDR/RR-TB cases and 48% for XDR-TB cases
  • A study published last month found that the BPaL and BPaLM (BPaL + moxifloxacin) regimens lead to significant cost savingsStudies estimate that adopting this regimen could save $740 million globally annually. India treats a third of the world’s MDR/RR-TB cases, which could mean nearly $250 million in savings annually for our country. 

 

WHO Recommendations and Progress in India:

  • The World Health Organization recommended the six-month BPaL and BPaLM regimens in 2022 as effective treatment options for most drug-resistant TB cases.
  • According to WHO’s Global TB Report 2023, India has improved its TB case detection and treatment coverage to 80% of estimated cases, a 19% increase over the previous year.
  • The estimated number of drug-resistant TB cases in India has decreased by 21% from 1.4 lakh in 2015 to 1.1 lakh in 2022.

 

The BPaL Regimen

  • It is a shorter, more effective treatment option for MDR-TB and XDR-TB patients. 
  • Unlike the traditional treatment duration of 18-24 months with up to 14 different drugs, the BPaL regimen reduces the treatment duration to approximately six months with just three daily tablets
  • This regimen has shown an 89% success rate, significantly higher than the 52% success rate of standard care.
  • Recommended by the US FDA in 2019 and the WHO in 2022, has been implemented in over 70 countries, including South Africa, Ukraine, Indonesia, Pakistan, Afghanistan, the Philippines, and Vietnam.

 

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