New drugs save lives of patients with multidrug-resistant TB in Belarus

WHO/M Dondyuk

Belarus started treating MDR-TB patients with new drugs in 2015. Results from the first group who completed the treatment show a significantly improved success rate.

For many patients with multidrug-resistant tuberculosis (MDR-TB), treatment with new drugs (bedaquiline and delamanid) is often the only possibility for survival, as other treatment options may have become ineffective. In Belarus, the new regimen has recently demonstrated that it can make significant improvements, achieving over 90% success in the first group of MDR-TB patients treated with the new drugs. While only a few of these patients had comorbidities such HIV-associated TB, alcohol dependence syndrome and others, results convincingly demonstrated the considerable potential of new TB drugs in substantially increasing successful treatment outcomes.

A major step towards TB elimination

Within a group of 192 MDR-TB patients who started treatment in Belarus with bedaquiline-containing regimens between June 2015 and March 2016, 178 patients (92.7%) were treated successfully; 9 (4.7%) did not complete the treatment; 3 (1.6%) died, and for 2 (1%) treatment failed.

These results, presented at the First Congress of Pulmonologists and TB Doctors of Belarus, represent a major step forward compared to the 58% success rate among other MDR-TB patients who started treatment in 2015 without the new drugs. They compare equally favourably with the WHO European Region average treatment success rate for MDR-TB patients (55%) and extensively drug-resistant TB (XDR-TB) patients (23%).

Results from Belarus are very encouraging for countries engaged in achieving the regional target of 75% treatment success rate for MDR-TB, set in the Tuberculosis Action Plan for the European Region 2016–2020. Replicating this success in other countries and settings would constitute a huge leap forward on the path to reaching TB elimination, and ending the suffering of millions of people worldwide.

WHO’s targeted support to Belarus

Belarus has the highest proportion of MDR-TB among new patients in the world, and has a substantial share of XDR-TB among these. Treatment for XDR- and MDR-TB patients is expensive, long and prone to adverse side effects.

WHO/Europe has been providing continuous technical support to Belarus for the introduction of new TB drugs and the development of national guidelines on management of TB and MDR-TB, on drug safety monitoring and on the use of new TB drugs. With support from the Global Fund to Fight AIDS, Tuberculosis and Malaria, the WHO Country Office in Belarus contracted 14 national specialists to ensure adequate active TB drug safety monitoring and management (aDSM) while treating MDR-TB patients with new drugs.