Asia-Pacific Gets New Weapon In Fight Against Drug-resistant TB

Drug-resistant tuberculosis (TB) is a major global health concern, with an estimated 558,000 new cases and 210,000 deaths reported annually according to the World Health Organization (WHO). The disease is particularly challenging to treat due to its resistance to standard antibiotics, requiring longer and more complex treatments that can last up to two years or more.

In an effort to combat this issue, the Asia-Pacific region is now set to receive a new weapon in its fight against drug-resistant TB in the form of Bedaquiline and Delamanid, two newer and more effective drugs that have shown promise in treating this formidable disease.

Bedaquiline, developed by Janssen Pharmaceuticals, was approved by the US Food and Drug Administration (FDA) in 2012 and by the European Medicines Agency (EMA) in 2013. It is the first fully oral, once-daily, directly acting anti-TB drug to be approved in over 40 years. Bedaquiline has shown to be effective against both drug-susceptible and drug-resistant TB strains, including those resistant to bedaquiline itself.

Delamanid, developed by Otsuka Pharmaceutical Co., Ltd., was approved by the EMA in 2014 for the treatment of multidrug-resistant TB (MDR-TB) patients with pulmonary disease who are intolerant to or have failed at least two second-line anti-TB drugs. Delamanid has also shown efficacy against extensively drug-resistant TB (XDR-TB), a subtype of MDR-TB that is resistant to second-line drugs as well as some first-line drugs.

The rollout of these two drugs in the Asia-Pacific region marks a significant step forward in the fight against drug-resistant TB. The WHO has recommended the use of Bedaquiline and Delamanid as part of the best available treatment regimens for MDR-TB and XDR-TB, respectively. The use of these drugs is expected to lead to shorter treatment durations, improved patient outcomes, and reduced transmission of drug-resistant strains.

The availability of these new drugs comes at an opportune time as the Asia-Pacific region accounts for approximately 60% of the global burden of MDR-TB and XDR-TB cases. The implementation of these drugs will not only benefit individual patients but also contribute to the overall control of drug-resistant TB in the region and beyond.

The rollout of these drugs is not without challenges, however. Affordability remains a significant concern as both Bedaquiline and Delamanid are expensive. The cost of Bedaquiline is estimated to be around $960 per patient per course, while Delamanid costs around $12,000 per patient per course. The high cost may limit their accessibility to many patients, particularly those in low- and middle-income countries.

In conclusion, the rollout of Bedaquiline and Delamanid in the Asia-Pacific region marks a new era in the fight against drug-resistant TB. These drugs offer hope for patients with MDR-TB and XDR-TB, as well as the potential to reduce the transmission of drug-resistant strains. However, affordability remains a significant challenge that must be addressed to ensure these life-saving drugs reach those who need them most.