Making the Switch

Previously recommended drug-resistant tuberculosis (DR-TB) treatment regimens used by most countries had a high pill burden, long treatment duration (of up to two years), painful daily injections (for up to eight months), severe side effects (due to toxic drugs) and poor treatment outcomes. These suboptimal regimens achieved treatment success rates of only 56% for people with multidrug-resistant/rifampicin-resistant TB (MDR/RR-TB) and 34% for people with XDR-TB.

New evidence on DR-TB management from clinical trials and observational cohorts has been emerging more frequently in recent years. WHO guidelines have kept pace, issuing new MDR/RR-TB treatment guidelines in March 2019, as well as a Rapid Communication with further updates in December 2019. This technical brief provides a summary of the treatment regimens now recommended by WHO, which represent hope for people with DR-TB and their caregivers because they offer better cure rates and fewer side effects using safer, shorter all-oral treatment.

Médecins Sans Frontières (MSF) urges countries to make a timely switch to these regimens given the clear benefits of providing bedaquiline for all people with MDR-TB and the urgent need to discontinue use of harmful injectable agents.