India's fight against Multi-Drug-Resistant Tuberculosis (MDR-TB) has received new ammunition with the Centre giving nod for the shorter and safer BPaLM regimen (bedaquiline, pretomanid, linezolid, and optionally moxifloxacin), with a target to eliminate the deadly disease by 2025, five years ahead of the global goal.” While traditional MDR-TB regimen can last up to 20 months with severe side effects, BPaLM course can cure the drug-resistant TB in just six months with a high treatment success rate,” said an official from the Union Health Ministry.

The regimen is a key component of the National TB Elimination Program (NTEP). Pretomanid has earlier been approved and licensed for use in India by the Central Drugs Standard Control Organization (CDSCO). The BPaLM regimen has been proven to be safe, more effective and a quicker treatment option than the previous MDR-TB treatment procedure, a senior official from the Ministry said.

“India's 75,000 drug-resistant TB patients will now be able to avail the benefit of this shorter regimen,” the official added.

The Department of Health and Family Welfare, in consultation with the Department of Health Research ensured the validation of this new TB treatment regimen that witnessed a thorough review of evidence by in-country subject experts.

A country-wide time-bound rollout plan of the BPaLM regimen is being prepared by the Central TB Division of the Ministry of Health and Family Welfare in consultation with the States and UTs.

According to Soumya Swaminathan, principal advisor, NTEP, “the move should improve treatment outcomes and help thousands of patients.”

As per her statement on Social media X posted a few days ago: “India is getting ready to roll out BPaL regimen for all M/XDRTB patients — training to begin this month. This should improve treatment outcomes & help thousands of patients. Scaling up NAAT coverage will be an essential element of the strategy.”

Leena Menghaney, South Asia head of Médecins Sans Frontières (MSF), called it a significant development in the fight against drug-resistant TB. She noted that the availability of generic bedaquiline has cut down treatment costs, with the BPaLM regimen priced at USD 426 (USD 130 for bedaquiline, USD 238 for pretomanid, USD 31 for linezolid, and USD 27 for moxifloxacin).

“This development marks a pivotal moment for those with drug-resistant TB, as India transitions to the more effective, safer, and shorter BPaLM regimen, which is likely to improve cure rates significantly.”