INDIA INTRODUCES BEDAQUILINE, PRETOMANID, AND LINEZOLID(BPAL) REGIMEN FOR DRUG-RESISTANT TUBERCULOSIS

Why in the news?

India is set to roll out the BPaL regimen for drug-resistant tuberculosis, reducing treatment time to six months, with training for implementation starting this month.

Introduction of BPaL Regimen:

  • India is set to roll out the BPaL regimen, a new treatment for multidrug-resistant (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB)
  • The BPaL regimen consists of bedaquiline, pretomanid, and linezolid.
  • Training for this regimen will begin this month, with expectations to significantly improve treatment outcomes.

Benefits of BPaL Regimen:

  • The BPaL regimen reduces treatment duration to approximately six months, compared to the previous 18-24 months.
  • This new treatment is anticipated to be more effective, safer, and less burdensome for patients.
  • BPaL is also more cost-effective, reducing the financial burden on both health systems and patients.

Global and National Impact:

  • The BPaL regime has shown promising results in countries like Pakistan, South Africa, and Ukraine.
  • The introduction of this regimen is a significant step in India’s National Tuberculosis Elimination Programme.
  • Experts, including Soumya Swaminathan and Leena Menghaney, have highlighted the regimen’s potential to transform TB treatment in India, making it more accessible and efficient.
INDIA INTRODUCES BEDAQUILINE, PRETOMANID, AND LINEZOLID(BPAL) REGIMEN FOR DRUG-RESISTANT TUBERCULOSIS - UPSCsource:medium
Key Facts about Bedaquiline, Pretomanid, and Linezolid(BPaL):

  • BPaL Combination: BPaL is a combination therapy consisting of three antibiotics: bedaquiline, pretomanid, and linezolid.
  • Development: Pretomanid was developed by TB Alliance, and bedaquiline by Johnson & Johnson, while linezolid is an older, generic drug.

Status in India:

  • Clinical Trials: BPaL is currently under clinical trials in India and might be integrated into the national TB programme once approved.
  • Drug Approval: All three drugs—bedaquiline, pretomanid, and linezolid—are already approved for use in India.

Administration and WHO Approval:

  • Oral Regimen: BPaL is administered as an oral regimen.
  • WHO Endorsement: The World Health Organization (WHO) has approved regimens containing pretomanid for treating all forms of drug-resistant tuberculosis (TB).

Key facts about Tuberculosis:

  • Cause: Caused by Mycobacterium tuberculosis bacteria, primarily affecting the lungs.

Transmission:

  • Spread through the air by coughing, sneezing, or spitting by infected individuals.
  • Inhalation of a few germs can cause infection.
  • TB infection can remain inactive until the immune system weakens.
  • Symptoms: Prolonged cough, chest pain, fatigue, weight loss, fever. Symptoms are often mild, leading to delayed diagnosis and increased transmission risk.

Diagnosis and Treatment:

Diagnosis:

  • Sputum sample testing for lung TB; fluid/tissue samples for non-lung TB.
  • WHO recommends rapid molecular diagnostic tests, sputum smear microscopy, and chest X-rays.

Treatment:

  • TB is curable with a 6-month antibiotic course (e.g., rifampicin, isoniazid).
  • Drug-resistant TB requires longer, complex treatment (e.g., Bedaquiline).
  • TB preventive treatment is available for infections to prevent disease onset.

Global and Indian Efforts:

  • Global Efforts: WHO’s Global Tuberculosis Programme, UN SDG target 3.3 (ending TB by 2030), Moscow Declaration 2017.

Indian Efforts:

  • Goal: TB-free India by 2025.
  • National Tuberculosis Elimination Programme under the National Strategic Plan (Detect-Treat-Prevent-Build).
  • Universal Immunisation Programme, Revised National TB Control Programme, NIKSHAY portal, TB Sample
  • Transport Network.
  • National Framework for a Gender-Responsive approach to TB.

Associated Article:

https://universalinstitutions.com/eliminating-tuberculosis/