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Open Access Global programmatic use of bedaquiline and delamanid for the treatment of multidrug-resistant tuberculosis

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SETTING: The World Health Organization recommended two new drugs, bedaquiline (BDQ) and delamanid (DLM), for the treatment of multidrug-resistant tuberculosis (MDR-TB) in 2013 and 2014, respectively. An estimated one third of patients with MDR-TB would benefit from the inclusion of these drugs in their treatment regimens.

DESIGN: A convenience sample of 36 countries voluntarily reported monthly data on cumulative programmatic use of new drugs to the Drug-Resistant TB Scale-Up Treatment Action Team between 1 July 2015 and 31 June 2017. Programmatic use was defined as treatment for MDR-TB with newer drugs outside of clinical trials or compassionate use.

RESULTS: A total of 10 164 persons were started on BDQ and 688 started on DLM during the reporting period. Only 15.7% of the 69 213 persons estimated to need newer drugs over the study period were reported to have received them.

CONCLUSION: While there has been significant progress in some countries, uptake of the newer drugs has not kept pace with a conservative estimate of need; fewer than 20% of persons likely to benefit from either BDQ or DLM have received them. Concerted efforts are needed to ensure that the newer drugs are made available more widely for persons with MDR-TB in need of these therapeutic options.
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Keywords: bedaquiline; delamanid; drug-resistant TB; global use

Document Type: Research Article

Affiliations: 1: Drug-Resistant TB Scale-Up Treatment Action Team, Global Drug-Resistant Tuberculosis Initiative, Stop TB Partnership, Geneva, Switzerland, Center for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa 2: International Union Against Tuberculosis and Lung Disease, Geneva 3: Global Drug Facility, Stop TB Partnership, Geneva, Switzerland 4: Treatment Action Group, New York, New York 5: Médecins Sans Frontières Access Campaign, New York, New York 6: Partners In Health, Boston, Massachusetts, Brigham and Women's Hospital, Boston, Massachusetts 7: Partners In Health, Boston, Massachusetts, Harvard Medical School, Boston, Massachusetts, USA

Publication date: 01 April 2018

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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