Experts stress on introducing BPaL treatment regimen in India’s TB Control Programme

New Delhi: A group of experts have stressed the need for introducing the BPaL regimen in the tuberculosis control programme of the country, saying it offers not only a significantly shorter treatment duration but has a direct impact on treatment adherence, leading to improved outcomes.

In the fight against DR-TB, the BPaL regimen which comprises three drugs –Bedaquiline, Pretomanid, and Linezolid, offers hope for a shorter, safer, and more tolerable treatment option. This groundbreaking regimen, with a treatment duration of just 26 weeks, stands in stark contrast to the existing conventional treatment for DR-TB, which can require patients to take over 4,000 to 5,000 tablets over 18 to 21 months.

The BPaL regimen, which has received recommendations from the U.S. Food and Drug Administration (FDA) in 2019 and the World Health Organization (WHO) in 2022, has already been rolled out in over 70 countries, including South Africa, Ukraine, Indonesia, Pakistan, Afghanistan, Philippines, and Vietnam. Patient advocacy groups and healthcare professionals worldwide are joining forces to urge the Indian government to prioritize its implementation.

Highlighting the key advantages of the BPaL regimen, Dr. Vikas Oswal, Renowned TB Specialist & National Technical Expert on TB, stated, “The BPaL regimen offers not only a significantly shorter treatment duration but also a drastic reduction in the number of tablets patients need to take. This has a direct impact on treatment adherence, leading to improved outcomes. Cure rates after completing 26 weeks of treatment are expected to exceed 89%, compared to the 60-65% cure rate seen with strict adherence to the conventional DR-TB Treatment, yet too early to comment on relapse rate, any regimen proves out to be successful if the relapse rate too is low.”

Blessina Kumar, Global Coalition of TB Advocates, expressed her eagerness for the BPaL regimen to be made available in India, stating, “Our TB patients have been suffering for far too long due to the gruelling and lengthy treatment regimens. The BPaL regimen promises a chance for a better quality of life. We urge the Indian government to prioritize the rollout of this regimen to help us achieve the End TB goals by 2025.”

Dr Ravikant Singh, Founder, Doctors For You, emphasized the urgency of introducing the BPaL regimen in India, stating, “BPaL regimen has shown remarkable success in numerous countries, offering a ray of hope for drug-resistant TB patients. Apart from being highly efficacious and cost-effective, it is also a very simple regimen to understand and roll out by healthcare workers. This regimen significantly reduces the logistics cost to treat TB cases which leads to overall reduction in treatment cost for DR TB patients. I hope the Govt of India will soon launch this regimen to achieve the UN target of Ending TB by 2030.”

“Studies estimate an annual global savings of $740 million due to the adoption of this regimen. Given that India accounts for a third of the global MDR/RR-TB treated patients, this could translate to savings of nearly $250 million per year for our country. Beyond the economic benefits, we cannot ignore the improved quality of life it promises to TB patients,” added Ms Kumar.

While the BPaL regimen has already proven its worth in numerous countries, India, with its high TB burden, is yet to introduce it into its treatment protocol. Advocates for TB patients and healthcare professionals are calling for immediate action to make this life-changing treatment option available to Indian patients.

The BPaL regimen presents a ray of hope for TB patients worldwide, offering a shorter, more effective, and economically viable treatment option. The urgent need to roll out this regimen in India is underscored by its potential to significantly impact the country’s fight against TB and improve the lives of countless patients.