Ground-breaking research conducted in South Africa to find shorter and more effective treatment for drug-resistant (DR) tuberculosis (TB) has resulted in global policy changes.
This research, conducted by the University of the Witwatersrand (Wits) and the Clinical HIV Research Unit (CHRU), formed part of clinical trials involving the Nix-TB and ZeNix studies conducted by the Global TB Alliance.
The trials conducted in South Africa produced robust data. Subsequently, the World Health Organization (WHO) announced key changes to the treatment of DR-TB. Treatment time has been reduced from 18 months to six months and the number of pills reduced from 23 a day to 23 per week, eliminating injections and reducing side-effects.
Treatment has been delivered to those in South Africa needing it most under the BPaL clinical access programme since March 2021.
The updates announced by the WHO include shorter novel six-month all-oral regimens for the treatment of multidrug and rifampicin-resistant TB (MDR/RR-TB). In addition, based on data from South Africa’s national TB programme, the WHO has also recommended an alternative nine-month all-oral regimen for the treatment of MDR/RR-TB.
The research also revealed that nine out of every ten patients treated with the new regimen will be cured, offering hope to those who have DR-TB. Through an early access programme, some DR-TB patients in the country are already benefiting from the new regimen.
According to Dr Norbert Ndjeka, appointed by the national Department of Health as chief director of TB, the new WHO guidelines allow almost all forms of DR-TB to be treated with either BPaLM or BPaL.
“South Africa has once again delivered trailblazing research which will improve outcomes for patients with DR-TB in the country and internationally,” said Ndjeka.
“This accomplishment has inspired us to continue our work in addressing the TB burden through research that produces better and shorter treatments that can cure the disease.”
Dr Francesca Conradie, an infectious diseases researcher in the School of Clinical Medicine at Wits, also confirms the advancements made.
“The treatment of drug resistant TB has been a rapidly changing field in the last ten years and new medicines for DR-TB have been rapidly incorporated into South Africa’s national TB programme,” said Conradie.
She’s also executive director of CHRU’s Isango Lethemba TB research unit and principal investigator of the Nix-TB and ZeNix clinical trials.
