Rachel V Thomas

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TB Treatment in 4 Months With 3 or Fewer Injections? WHO Pushes for Long-Acting Options

<span><a href="https://www.healthandme.com/health/tuberculosis">Tuberculosis</a></span> (TB) remains the world’s leading cause of death from a single infectious agent. Treatment typically involves daily oral medicines that is taken for over weeks or months, making adherence a challenge for many patients.

To tackle this, the World Health Organization (WHO) has now released target regimen profiles for long-acting injectables (LAIs), which may soon replace pills with injections for TB preventive treatment and TB disease.

The new treatment regimen for <a href="https://www.healthandme.com/health/tuberculosis" data-type="tilCustomLink">tuberculosis</a> with LAIs targets three or fewer injections in just four months. 

These treatments are not yet commercially available for routine clinical use, but several candidates are entering clinical development.

“Long-acting injectables could make TB prevention and treatment much simpler for the people who need them. These profiles tell developers, early, what a new regimen must achieve to make that difference in practice, without trading away efficacy, safety or patient choice,” said Dr. Tereza Kasaeva, director of the WHO Department for HIV, Tuberculosis, Hepatitis and <span>Sexually Transmitted Infections</span>.

<h2>What Are the WHO’s Targets for Long-Acting TB Injections?</h2>

<strong>Also read: </strong><a href="https://www.healthandme.com/health-news/94-of-tb-patients-report-anxiety-77-depression-study-highlights-mental-health-toll-of-indias-tb-burden-article-156366419" data-type="tilCustomLink">94% Of TB Patients Report Anxiety, 77% Depression: Study Highlights Mental Health Toll Of India's TB Burden</a>

The WHO’s target regimen profiles (TRPs) define the minimum and optimal requirements for developing LAIs for TB prevention and treatment, guiding pharmaceutical companies, researchers, product developers, donors and TB-affected communities.

"The profile for TB preventive treatment aims for a complete course delivered through a single injection during one healthcare encounter. For TB disease, the target is a regimen lasting no more than four months, delivered in three or fewer dosing encounters," the WHO said.

Both profiles call for injections administered by trained health workers at the lowest feasible level of the health system. They also specify small injection volumes, no requirement for a cold chain, and efficacy and safety at least comparable to those of existing oral regimens. The profiles also address clinical trial design, scalability, equitable access and affordability.

<h2>How Could Long-Acting Injections Help People With TB?</h2>

<strong>Read More: </strong><a href="https://www.healthandme.com/health-wellness/icmrs-advanced-blood-test-to-predict-risk-of-tb-1-5-years-before-symptoms-appear-article-153890023" data-type="tilCustomLink">ICMR's Advanced Blood Test to Predict Risk of TB 1.5 Years Before Symptoms Appear</a>

LAIs are sustained-release medicines administered through intramuscular or subcutaneous injections. They have shown previously shown potential in managing conditions including HIV, schizophrenia, opioid dependence and contraception.

For HIV prevention, long-acting cabotegravir is administered every two months, while lenacapavir is administered twice yearly. WHO recommended lenacapavir for HIV prevention in 2025.

For people affected by TB, potential benefits include:

<ul><li>Simpler adherence: Fewer doses could make it easier to complete treatment.</li><li>Lower risk of drug resistance: Better adherence could reduce the risk of resistance developing during treatment.</li><li>Reduced treatment burden: Fewer pills and healthcare visits could mean less time away from work and lower travel costs.</li><li>Less stigma: Less frequent medication-taking and fewer healthcare visits could ease some of the burden associated with treatment.</li></ul>

However, LAIs address medication-taking frequency and adherence, not every challenge in TB care. Effective implementation would still require timely diagnosis, appropriate testing, management of comorbidities and drug interactions, contact investigation, and adequate healthcare resources.

<h2>Will Long-Acting TB Injections Be Affordable?</h2>

The WHO expects LAIs for TB prevention and treatment to enter the market at higher prices than existing oral formulations, based on anticipated development and production costs. International collaboration and support may be needed to ensure affordability, particularly during the initial rollout.

The WHO also emphasized that research into improved oral regimens should continue. Treatment programmes must preserve patient choice, allowing people who prefer oral medicines to continue using them.

According to the WHO’s <span>Global <a href="https://www.healthandme.com/health/tuberculosis">Tuberculosis</a> Report</span> 2025, more than 10 million people developed TB worldwide in 2024, while more than 1.2 million died from the disease.

India bears the largest share of the global TB burden. Prolonged treatment, financial hardship, stigma and uneven access to drug-resistant TB care can make treatment more challenging.

If successfully developed and made accessible, long-acting injections could reduce some of the practical and economic barriers associated with TB treatment. Their impact will depend on safety, efficacy, affordability and equitable access.

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Tuberculosis (TB) remains the world’s leading cause of death from a single infectious agent. Treatment typically involves daily oral medicines that is taken for over weeks or months, making adherence a challenge for many patients.To tackle this, the World Health Organization (WHO) has now released target regimen profiles for long-acting injectables (LAIs), which may soon replace pills with injections for TB preventive treatment and TB disease. The new treatment regimen for tuberculosis with LAIs targets three or fewer injections in just four months. These treatments are not yet commercially available for routine clinical use, but several candidates are entering clinical development.“Long-acting injectables could make TB prevention and treatment much simpler for the people who need them. These profiles tell developers, early, what a new regimen must achieve to make that difference in practice, without trading away efficacy, safety or patient choice,” said Dr. Tereza Kasaeva, director of the WHO Department for HIV, Tuberculosis, Hepatitis and Sexually Transmitted Infections.What Are the WHO’s Targets for Long-Acting TB Injections?Also read: 94% Of TB Patients Report Anxiety, 77% Depression: Study Highlights Mental Health Toll Of India's TB BurdenThe WHO’s target regimen profiles (TRPs) define the minimum and optimal requirements for developing LAIs for TB prevention and treatment, guiding pharmaceutical companies, researchers, product developers, donors and TB-affected communities."The profile for TB preventive treatment aims for a complete course delivered through a single injection during one healthcare encounter. For TB disease, the target is a regimen lasting no more than four months, delivered in three or fewer dosing encounters," the WHO said.Both profiles call for injections administered by trained health workers at the lowest feasible level of the health system. They also specify small injection volumes, no requirement for a cold chain, and efficacy and safety at least comparable to those of existing oral regimens. The profiles also address clinical trial design, scalability, equitable access and affordability.How Could Long-Acting Injections Help People With TB?Read More: ICMR's Advanced Blood Test to Predict Risk of TB 1.5 Years Before Symptoms AppearLAIs are sustained-release medicines administered through intramuscular or subcutaneous injections. They have shown previously shown potential in managing conditions including HIV, schizophrenia, opioid dependence and contraception.For HIV prevention, long-acting cabotegravir is administered every two months, while lenacapavir is administered twice yearly. WHO recommended lenacapavir for HIV prevention in 2025.For people affected by TB, potential benefits include:Simpler adherence: Fewer doses could make it easier to complete treatment.Lower risk of drug resistance: Better adherence could reduce the risk of resistance developing during treatment.Reduced treatment burden: Fewer pills and healthcare visits could mean less time away from work and lower travel costs.Less stigma: Less frequent medication-taking and fewer healthcare visits could ease some of the burden associated with treatment.However, LAIs address medication-taking frequency and adherence, not every challenge in TB care. Effective implementation would still require timely diagnosis, appropriate testing, management of comorbidities and drug interactions, contact investigation, and adequate healthcare resources.Will Long-Acting TB Injections Be Affordable?The WHO expects LAIs for TB prevention and treatment to enter the market at higher prices than existing oral formulations, based on anticipated development and production costs. International collaboration and support may be needed to ensure affordability, particularly during the initial rollout.The WHO also emphasized that research into improved oral regimens should continue. Treatment programmes must preserve patient choice, allowing people who prefer oral medicines to continue using them.Why Does This Matter for India?According to the WHO’s Global Tuberculosis Report 2025, more than 10 million people developed TB worldwide in 2024, while more than 1.2 million died from the disease.India bears the largest share of the global TB burden. Prolonged treatment, financial hardship, stigma and uneven access to drug-resistant TB care can make treatment more challenging.If successfully developed and made accessible, long-acting injections could reduce some of the practical and economic barriers associated with TB treatment. Their impact will depend on safety, efficacy, affordability and equitable access.

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