Implementing novel regimens for drug-resistant TB in South Africa: what can the world learn?. Ndjeka, N, Hughes, J, Reuter, A, Conradie, F, Enwerem, M, Ferreira, H, Ismail, N, Kock, Y, Master, I, Meintjes, G. A, Padanilam, X, Romero, R, Schaaf, H S, te Riele, J, & Maartens, G. The International Journal of Tuberculosis and Lung Disease, 24(10):1073–1080, oct, 2020.
Implementing novel regimens for drug-resistant TB in South Africa: what can the world learn? [link]Paper  doi  abstract   bibtex   
Worldwide uptake of new drugs in the treatment of rifampicin-resistant tuberculosis (RR-TB) has been extremely low. In June 2018, ahead of the release of the updated WHO guidelines for the management of RR-TB, South Africa announced that bedaquiline (BDQ) would be provided to virtually all RR-TB patients on shorter or longer regimens. South Africa has been the global leader in accessing BDQ for patients with RR-TB, who now represent 60% of the global BDQ cohort. The use of BDQ within a shorter modified regimen has generated the programmatic data underpinning the most recent change in WHO guidelines endorsing a shorter, injectable-free regimen. Progressive policies on access to new drugs have resulted in improved favourable outcomes and a reduction in mortality among RR-TB patients in South Africa. This supported global policy change. The strategies underpinning these bold actions include close collaboration between the South African National TB Programme and partners, introduction of new TB diagnostic tools in closely monitored conditions and the use of locally generated programmatic evidence to inform country policy changes. In this paper, we summarise a decade´s work that led to the bold decision to use a modified, short, injectable-free regimen with BDQ and linezolid under carefully monitored programmatic conditions.
@article{Ndjeka2020a,
abstract = {Worldwide uptake of new drugs in the treatment of rifampicin-resistant tuberculosis (RR-TB) has been extremely low. In June 2018, ahead of the release of the updated WHO guidelines for the management of RR-TB, South Africa announced that bedaquiline (BDQ) would be provided to virtually all RR-TB patients on shorter or longer regimens. South Africa has been the global leader in accessing BDQ for patients with RR-TB, who now represent 60{\%} of the global BDQ cohort. The use of BDQ within a shorter modified regimen has generated the programmatic data underpinning the most recent change in WHO guidelines endorsing a shorter, injectable-free regimen. Progressive policies on access to new drugs have resulted in improved favourable outcomes and a reduction in mortality among RR-TB patients in South Africa. This supported global policy change. The strategies underpinning these bold actions include close collaboration between the South African National TB Programme and partners, introduction of new TB diagnostic tools in closely monitored conditions and the use of locally generated programmatic evidence to inform country policy changes. In this paper, we summarise a decade´s work that led to the bold decision to use a modified, short, injectable-free regimen with BDQ and linezolid under carefully monitored programmatic conditions.},
author = {Ndjeka, N and Hughes, J and Reuter, A and Conradie, F and Enwerem, M and Ferreira, H and Ismail, N and Kock, Y and Master, I and Meintjes, Graeme A and Padanilam, X and Romero, R and Schaaf, H S and te Riele, J and Maartens, Gary},
doi = {10.5588/ijtld.20.0174},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Ndjeka et al. - 2020 - Implementing novel regimens for drug-resistant TB in South Africa what can the world learn.pdf:pdf},
issn = {1027-3719},
journal = {The International Journal of Tuberculosis and Lung Disease},
keywords = {OA,fund{\_}not{\_}ack,review},
mendeley-tags = {OA,fund{\_}not{\_}ack,review},
month = {oct},
number = {10},
pages = {1073--1080},
pmid = {33126942},
title = {{Implementing novel regimens for drug-resistant TB in South Africa: what can the world learn?}},
url = {https://www.ingentaconnect.com/content/10.5588/ijtld.20.0174},
volume = {24},
year = {2020}
}

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