WHO finalizes MDR-TB treatment guidance recommending shift from injections

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Including recommendations that injected drugs with permanent debilitating side effects not be included in longer treatment regimens against multidrug-resistant tuberculosis, and the inclusion of the most recently added drugs, bedaquiline and delamanid in those treatments, the World Health Organization today released updated guidelines for treating TB that does not respond to first line treatments.

The guidelines formalize a shift away from the toxic, painful injections that comprised one of many, and among the most challenging hurdles to completing treatment and curing drug-resistant tuberculosis, was announced in August, and outlined in draft document released in late December. The guidelines are part of a larger plan aiming to speed access to successful treatment for tuberculosis worldwide.

WHO’s 2018 Global TB Report showed about 10 million people developed the disease in the preceding year, and that daily, the disease had cost about 4,000 people their lives, with— 1.3 million people killed by tuberculosis that year. Of them more than a million had developed disease resistant to one or more of the first-line, least toxic, most effective and affordable drugs used to treat the disease, that has necessitated longer, more expensive, frequently inaccessible regimens with side effects that include deafness.

Advocates for more effective and far-reaching responses to the global impacts of tuberculosis have praised the recommendations but noted they highlight needs for reduced prices for the newer drugs, and accelerated regulatory approvals allowing their widespread use.

The guidelines, released in the week before World Tuberculosis Day, which commemorates the March 24, 1882 discovery of the bacterium causing the disease, will be included as well in WHO’s handbook for national TB programs.

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