TB Alliance’s mission can only be achieved if new and improved TB medicines reach the millions around the world suffering from the disease. Many new milestones were reached in 2022 to help achieve this goal – with updates to the WHO guidelines, expanded access through operational research and other global access programs. Find out more about recent updates on the impact for TB treatment globally.

BPaL/M Included in Updated WHO Guidelines for DR-TB Treatment

Building on evidence first developed by TB Alliance, almost all patients with DR-TB can now be treated in six months with an all-oral regimen. New World Health Organization (WHO) guidelines allow for the programmatic implementation of treating almost all forms of drug-resistant tuberculosis (DR-TB) with either BPaLM (a combination of bedaquiline, pretomanid, linezolid and moxifloxacin) or BPaL (bedaquiline, pretomanid and linezolid).

The Ukraine Experience: Implementing the BPaL Regimen

Ukraine was the first high-burden country to adopt the BPaL regimen, enrolling patients beginning in December 2020. A shortened, simplified treatment for DR-TB has been an especially welcome advance for patients who needed treatment amid wartime conditions. As the war began in February 2022, 50 Ukrainian patients were given the remainder of their full treatment course so the remaining duration of their treatment could be completed remotely. 47 of 50 such patients were successfully monitored, all of whom successfully completed treatment. Overall, more than 90% of Ukrainian patients who completed DR-TB treatment with BPaL 6+ months ago remain TB-free, a finding consistent with clinical studies of the regimen. These outcomes would have been extraordinarily difficult using the longer, more toxic, and less effective treatments that were in place prior to BPaL. Ukraine’s National TB Program is now moving quickly to scale up access to BPaL on a nationwide basis. Despite the ongoing invasion by Russia, patients on BPaL in Ukraine have been able to continue their treatment even when TB hospitals were under assault or even destroyed.

Life-saving and Cost-saving

A new study published in PLOS Global Public Health found that the BPaL/BPaLM treatment regimens that are now included in the WHO guidelines for the treatment of DR-TB could save governments up to US$740 million annually, which is enough to fund almost another year’s worth of DR-TB treatments for more than 400,000 people. The study estimates that the cost of implementing this therapy is potentially 40-90% less expensive than current regimens.

At the end of 2022, TB Alliance also entered into a new partnership with Viatris and MedAccess to reduce the price of pretomanid by 34%. This price reduction will help pave the way for further expanded access to highly effective, pretomanid-containing treatment regimens for DR-TB patients globally.

The Year in Photos

2022 was a year that marked progress throughout the organization. TB Alliance saw developments in strengthening and developing our research pipeline, but we’ve also seen progress in delivering treatments by ensuring that people around the world have access to shorter, more effective regimens for drug-resistant TB.

Browse the entire gallery on Pixieset

SPOTLIGHT: Volodymyr’s Story of TB Courage in Ukraine

Volodymyr was a resident physician in Kyiv in February 2021 when war broke out in Ukraine. He was diagnosed with tuberculosis after two weeks of cough and fever. “Around February 20th, I was dismissed with the prescribed treatment, with the BPaL method.” When Russia invaded Ukraine, Volodymyr, “didn't believe it.” He said, “I woke up to my parents, they said: ‘Are you kidding us? It can't be true. A war? With Russia? Why?’ And on February 25th, we were already under occupation.” Volodymyr only had enough antibiotics for two weeks, but his doctor was able to send him more medicine for another month. Reflecting on living with TB under wartime conditions, he said, “In general, things that were difficult in peacetime, are ten times more difficult in wartime […] If [treatment] lasts for a year, two, one and a half, it will be more difficult in such situations.”

Annual Report 2022