South Africa’s Department of Health has become the first country in the world to roll out a new and more tolerable drug to fight multidrug-resistant tuberculosis (MDR-TB).

The new drug‚ bedaquiline‚ would replace current treatment regimens for adolescents and adults from the start of their treatment.

Until now, injectables were used to treat TB but they are notorious for their harsh side effects. Known side effects of the injectables currently used include kidney failure and hearing loss.

“The standard treatment for MDR-TB is currently effective only 50% of the time, and includes a painful injectable antibiotic known to cause terrible toxic side effects, including kidney failure and hearing loss,” said Médecins Sans Frontières’ (Doctors Without Borders), Dr Anja Reuter, who is stationed in Khayelitsha in the Western Cape where the organisation has run a TB treatment programme since 2007.

“Experience with bedaquiline in treating drug-resistant TB – mainly from South Africa – demonstrates improved clinical outcomes in people living with MDR-TB, and initial evidence shows that it can be safely and effectively used in place of the toxic injectable,” continued Dr Reuter.

A progressive move

The progressive move by the South African Health Department to introduce bedaquiline for all patients is a historic achievement which comes after a long haul by many in South Africa to get more effective, less toxic treatment for those with MDR-TB and Extensively drug-resistant TB (XDR-TB), said Doctors Without Borders in a statement.

Up until now‚ the new drug had been rolled out in small pockets across the country‚ but this scale-up is likely to reduce the burden of the disease exponentially.

Each year more than half a million people are infected with MDR-TB across the world and South Africa carries a high burden of 19‚000 cases.

Doctors Without Borders says while there’s still some hurdles in implementation, health facilities must be supported in developing capacity to use bedaquiline and other new drugs, and to manufacturers to reduce the prices they charge in SA and globally.

The organisation also urged other countries and officials responsible for WHO guidance on the use of DR-TB medicines to follow South Africa’s “progressive example and commit to replacing the toxic injectable drug and ensuring expanded global access to effective new medicines, including bedaquiline.”

“There is no question we should be offering people the best options we have for more effective and less toxic treatment, but progress on this agenda has to date been slow in most countries. South Africa has taken a positive step towards ensuring that no one with DR-TB should be denied access to this drug,” concluded Dr Reuter.

Doctors Without Borders has also called on South Africa to “send the highest level delegation possible‚ including the president‚ deputy president‚ minister of health‚ and civil society members” to attend the first United Nations High-Level Meeting on TB to encourage other countries to follow in the country’s footsteps.

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