Tuberculosis (TB)

New additions to the WHO Essential Medicines List related to TB treatment

The 20th WHO Expert Committee meeting on the selection and use of essential medicines has recommended the inclusion of five medicines (bedaquiline, delamanid, linezolid, rifapentine and terizidone) in the anti- tuberculosis (TB) medicines section of the WHO Model List of Essential Medicines (EML). Rifapentine is indicated for the treatment of latent TB infection (LTBI). The other four medicines are used as part of treatment regimens for multidrug and extensively drug-resistant TB (MDR-TB and XDR-TB respectively), two conditions with high lethality and poor treatment outcomes. Bedaquiline and delamanid are two new drugs which have recently been granted conditional approval by stringent regulatory authorities for use in the treatment of MDR-TB. Linezolid and terizidone are old drugs and their off-label use for severe forms of drug-resistant TB has now also been approved by the EML.

The addition of these four medicines to the EML will help synergize the efforts of WHO, member states, donors and technical partners to improve access to life-saving treatment, to improve treatment outcomes of MDR- and XDR-TB and reduce avoidable mortality. About half a million patients are estimated to develop MDR-TB in the world every year. Rifapentine is a crucial drug within the public health approach to roll out systematic testing and treatment of LTBI in at-risk populations. The combination of rifapentine and isoniazid has advantages over other available options in terms of likelihood to complete treatment, safety, and acceptability to end-users. It also may significantly contribute to wider implementation of preventive therapy among people living with HIV at global level.

Dr Mario Raviglione, Director of WHO’s Global TB Programme, noted that having the “EML better equipped with the inclusion of these medicines will complement current WHO policies that guide Member States to design effective TB treatment regimens, drive the attention on the need for further research and active pharmacovigilance on these new medicines, and stimulate much-needed interest of drug manufacturers to invest more in the development of new anti-TB medicines and their registration in countries”.