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Faster and much more effective treatment for drug-resistant tuberculosis is being rolled out in Asia-Pacific, raising hopes of a “new era” in the fight against one of the world’s deadliest infectious diseases.
According to the World Health Organization (WHO), this region will account for the largest proportion of the 10.6 million new cases of tuberculosis worldwide in 2022, and more than half of 1.3 million deaths.
Although TB can be cured with antibiotics, more than 3% of new patients with the infectious disease have a drug-resistant form.
Until recently, treatments involved daily injections or large doses of tablets for at least 18 months, sometimes with strong side effects: nausea and, in extreme cases, blindness. Many patients abandoned their treatment.
A new product that is lighter and with fewer side effects is starting to be offered in the region, particularly in the Philippines, Vietnam and Indonesia. Trials have shown a cure rate of over 90% after six months.
The BPaL treatment, which combines the antibiotics bedaquiline, pretomanid and linezolid, has been approved in more than 60 countries, according to the nonprofit TB Alliance, which developed it.
For Filipino chef Efifanio Brillante, who suffered from a form of drug-resistant tuberculosis, the change was lifesaving. With his previous treatment, he had to swallow 20 tablets a day but felt so nauseous that he could neither work nor eat. He stopped after two weeks, despite the risks. ” It’s very difficult. You’re always in bed… Sometimes I couldn’t even breathe,” says the 57-year-old Filipino.
The following month, he participated in a trial of BPaL at a hospital in Pampanga province, north of Manila, the capital of the Philippines. With three to seven pills a day, he was cured after six months. “If I hadn’t taken this BPaL, I might already be in the cemetery,” he admits.
The poorest are affected
Tuberculosis is caused by bacteria that mainly attacks the lungs and is transmitted through the air by infected people.
Present in all countries, it mainly affects the poorest who live and work in overcrowded premises. In 2022, two-thirds of new cases were detected in eight countries: India, Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh and the Democratic Republic of Congo. One of the main challenges is to encourage patients, put off by costs, travel or side effects, to complete their treatment.
In Vietnam, almost all drug-resistant tuberculosis patients have faced “catastrophic” costs for their treatment, says Hoang Thi Thanh Thuy of Vietnam’s national tuberculosis control program.
Identifying patients and combating stigma is another difficulty. In Indonesia, some health establishments are still unable to correctly diagnose the disease, notes Imran Pambudi of the Ministry of Health.
Reduce the cost of treatment
After years of decline, tuberculosis began to rise again during the Covid-19 pandemic, which disrupted the diagnosis and treatment of the disease.
The WHO has called for an increase in funding. But “when TB ceased to be a problem for high-income countries, the motivation to invest in research and development of new drugs against the disease dried up,” notes Sandeep Juneja, a TB official. Alliance.
To accelerate the deployment of BPaL, TB Alliance opened a center in Manila to provide training and assistance to countries in the region. In India, which has the most cases in the world, we are impatiently awaiting the arrival of the drug.
“BPaL should be implemented quickly, it will save patients from many problems (…) while reducing the cost of treatment in the long term,” according to Ravikant Singh, founder of the public health NGO Doctors for You.
For Sandeep Juneja, the new treatment means that there is no longer any question about a patient’s chances of survival. “I hope this is just the beginning of a new era of TB treatment, with even simpler and shorter courses,” he says.
Pam CASTRO/AFP
Faster and much more effective treatment for drug-resistant tuberculosis is being rolled out in Asia-Pacific, raising hopes of a “new era” in the fight against one of the world’s deadliest infectious diseases. According to the World Health Organization (WHO), it is in this region that the greatest proportion of…
