Global Progress and Challenges in Implementing New Medications for Treating Multidrug-Resistant Tuberculosis

Abstract

Two new drugs-bedaquiline and delamanid-have recently been approved by stringent regulatory authorities to treat multidrug-resistant tuberculosis (TB) and recommended by the World Health Organization for use under defined programmatic conditions. Introducing the medications in TB programs worldwide has not kept pace with the need for these drugs. In response, the DR-TB STAT (Drug-Resistant TB Scale-up Treatment Action Team) task force was formed in April 2015 to monitor progress and help overcome challenges. Information was collected from multiple sources and assessed monthly. Some progress has been made in introducing bedaquiline: as of October 2015, a total of 1,258 persons were on the medication under programmatic conditions. For delamanid, >100 patients, but few under programmatic conditions, have received the medication. Coordinated global action might help assist making these medications accessible for persons who need them most.

Keywords: Mycobacterium tuberculosis and other mycobacteria; antimicrobial resistance; bacteria; bedaquiline; delamanid; drug-resistant TB; global progress.

Figure 1

Global progress on programmatic use of bedaquiline (BDQ) to treat multidrug-resistant tuberculosis. Blue indicates countries using BDQ under program conditions. Green indicates countries awaiting arrival of BDQ to use it under program conditions. Gray indicates countries that have not reported using BDQ under program conditions.

Figure 2

Global progress on the programmatic use of delamanid (DLM) to treat multidrug-resistant tuberculosis. Red shading indicates countries using DLM under program conditions. Gray indicates countries that have not reported using DLM under program conditions.