BPAL REGIMEN (Syllabus: GS Paper 2 – Health)

BPaL Regimen

• About: It is a groundbreaking approach for drug-resistant tuberculosis (DR-TB) utilizing bedaquiline, pretomanid, and linezolid.
• Consist of: Bedaquiline, Pretomanid, Linezolid and Moxifloxacin
• Duration: Unlike traditional DR-TB treatments that last 18 months, BPaL shortens the treatment period to just 26 weeks.
• Purpose and Focus: BPaL specifically targets drug-resistant tuberculosis, particularly for patients with pre-XDR TB or those who are unresponsive to MDR pulmonary TB treatments.
• Role of Pretomanid: It is a new anti-TB drug, plays a crucial role in the regimen. It has been approved and licensed for use in India by the Central Drugs Standard Control Organisation (CDSCO).
• Treatment Focus on MDR-TB: The BPaLM regimen specifically targets multi-drug resistant TB, offering a potentially more effective treatment option.
• Global Impact: The regimen has shown promising results in various countries, including Pakistan, South Africa, and Ukraine, marking a significant advancement in the fight against M/XDR-TB.
• NAAT Testing: A nucleic acid amplification test (NAAT) is used to detect the DNA of Mycobacterium tuberculosis complex (MTBC) in respiratory samples, aiding in TB diagnosis.
• Treatment Duration Comparison: BPaL reduces the treatment duration from the traditional 18 to 24 months to around 6 months.
• Simplified Medication: The previous all-oral regimen required nearly 14 different anti-TB drugs daily, while BPaL simplifies the regimen to just three daily tablets.

Current Status of TB in India:

• As per Global TB Report 2023, India had the highest prevalence of Tb. However, India’s efforts have resulted in reduction of TB incidence by 16% in 2022 (from 2015) almost double the pace at which global TB incidence is declining (which is 8.7%).
• India aims to eliminate tuberculosis (TB) by 2025, which is five years ahead of the global Sustainable Development Goals (SDGs) target of 2030.
• By adopting this regimen, India strengthens its efforts to meet its ambitious goal of eliminating TB by 2025.
• India’s treatment success rate is 56% for MDR/RR-TB cases and 48% for XDR-TB cases, largely due to prolonged and toxic drug regimens.