New drugs & treatment regimens

Woman_With_MDR_TB_at_DOTS_Hospital_Indonesia_Tristan _Bayly

Previously the treatment of patients who has drug-resistant TB was long (20 – 24 months) and used a large number of different drugs, many of which had potentially serious side-effects. It was no wonder that patients “feared” such long and challenging treatments. As a result, many patients would stop their treatment prior to completion and cure. Identifying shorter, more tolerable, yet effective treatments is part of the solution. Wide spread introduction of such regimens, with patient-centred care, is greatly needed, both by National TB Programs and by patients.

Care and treatment

With the development of the first new anti-TB drugs (i.e. bedaquiline, delamanid and pretomanid) for many decades and the re-purposing of existing drugs to treat DR-TB patients (e.g. clofazimine, fluoroquinolones and linezolid), we are now moving into the era when patients can be offered shorter and all oral treatment regimens for DR-TB, with fewer drugs. Hence the World Health Organization (WHO) is now recommending the use of injection free i.e. all oral, shorter treatment regimens (possibly of only six to nine months duration) for various forms of DR-TB. This is a huge step forwards for patients.

KNCV believes in patient-centered care, and is currently technically supporting ten countries to implement the newly recommended six to nine months, all-oral 4-drug, BPaL regimen to improve adherence and treatment success in a specific group of DR-TB patients. Currently WHO recommends that the so-called BPaL regimen be implemented under operational research (OR) conditions. Hence KNCV is providing the countries with the wide range of technical assistance to the ten countries required to introduce the BPaL regimen under OR conditions. This includes assistance to develop implementation plans, OR protocols, and training material, assessments of facility’s readiness to introduce the novel regimen, and introduction of the necessary active drug safety and monitoring systems and recording and reporting systems. Using the expert consultant team within KNCV, these activities are being supported via the KNCV Endowment Fund in Nigeria, TB REACH Wave 7 projects in Tajikistan and Ukraine, and under the TB Alliance / KOICA’s LIFT-TB project in seven countries (Indonesia, Kyrgyzstan, Myanmar, The Philippines, Ukraine, Uzbekistan and Vietnam).

KNCV has been fighting TB since its establishment in 1903. Over the past 120 years, the organization has acquired indispensable knowledge and experience in the field of effective TB prevention and care, resulting in pre-elimination in the Netherlands and significant contributions to global evidence generation, policy development and TB program implementation worldwide.

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Tuberculosis is still one of the major causes of preventable death in the world and claims over 4000 lives a day, leading to over 1,5 million deaths a year.

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