In a significant development that has unfortunately escaped local media attention but was highlighted by Ian Gachichio on behalf of TB Alliance, the Association for Social Development (ASD) has made noteworthy strides in the treatment of drug-resistant tuberculosis (DR-TB) in Pakistan.
The organization, through a pilot program, registered 206 participants for treatment with the recently recommended BPaL/M regimens by the World Health Organization (WHO). These regimens involve combinations of bedaquiline, pteromalid, and linezolid, with or without moxifloxacin.
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ASD reported a remarkable success rate, with 105 out of 113 participants (95%) experiencing successful treatment outcomes. This mirrors the success rates observed globally with the new regimens and signifies a substantial improvement over previous drug-resistant TB therapies. In response to these positive outcomes, Pakistan has promptly updated its treatment guidelines for DR-TB, endorsing the use of these six-month, all-oral regimens.
Since October 2022, ASD, in collaboration with Pakistan’s National TB Control Program (NTP) and TB Alliance, has been actively recruiting participants from four sites in Punjab and Khyber Pakhtunkhwa provinces: Leprosy Rawalpindi, Nishtar Multan, Jinnah Lahore, and Lady Reading Peshawar. ASD’s support included technical expertise, ensuring successful implementation, comprehensive training materials, adherence guidelines, and performance monitoring tools. The project drew on TB Alliance’s global experience in implementing BPaL/M regimens in various countries.
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One poignant success story is that of Ayesha, a young mother who had witnessed the arduous journeys of others battling drug-resistant tuberculosis in her community. When she fell ill herself, Ayesha enrolled in the pilot program for the BPaL/M regimen, experiencing quick relief and regaining her strength. The shortened duration and heightened effectiveness of the treatment allowed her to actively engage with her family again.
Ayesha shared her experience, stating, “The BPaL/M treatment emerged as a ray of sunshine in my life, with its completion taking just six months. Thanks to this remarkable breakthrough, I can now be present for my family and relish the simple joys of life once more.” Her husband, Ali, expressed gratitude for the transformative treatment, highlighting the notably fewer side effects encountered by Ayesha compared to others they knew.
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As the program progresses, ASD remains dedicated to promoting, supporting, and scaling up the implementation of BPaL/M treatments in Pakistan. Drawing insights from the initial four sites, the National Program has already initiated scaling at eight additional sites nationwide, with plans to expand to more than 40 DR-TB care sites in Pakistan. Additionally, TB Alliance’s commercialization partnership with Remington Pharmaceuticals promises to further enhance access to pretomanid and the BPaL/M regimens in the country.
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The writer is a lawyer, academic and political analyst. She has authored a book titled ‘A Comparative Analysis of Media & Media Laws in Pakistan.’ She can be contacted at: yasmeenali62@gmail.com and tweets at @yasmeen_9
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