Eswatini’s rollout of a six‑month all‑oral treatment regimen for multidrug‑resistant tuberculosis (MDR‑TB) is showing encouraging results, marking a significant shift in a country with one of the world’s highest TB burdens.
The BPaL(M) regimen, recommended by the World Health Organisation (WHO) in 2022 and adopted by Eswatini in 2023, replaced the older 18‑month course that relied on a complex mix of oral and injectable medicines.
Health workers say the shorter, injection‑free treatment is improving adherence and outcomes among patients who previously struggled to complete therapy.
“The shorter all-oral treatment regimen are preferable because they eliminate the need for painful daily injections, which can extend the treatment duration to up to 18 months, depending on the patient’s response,” said Majaha Mtshali, TB focal person and staff nurse at Piggs Peak hospital in northwestern Eswatini.
For 40‑year‑old Babazile Ngwenya from Manzini, the new regimen proved decisive.
After defaulting on treatment in 2012, she developed MDR‑TB and spent seven months in hospital without being cured.
“The drugs were too many, that’s why I was defaulting,” she said.
When she fell ill again in 2024, she was placed on the six‑month BPaL(M) regimen and recovered after adhering to the simplified course.
Eswatini has made progress in recent years, with 86 percent of MDR‑TB patients treated successfully in 2022 and TB deaths falling by 60 percent between 2015 and 2024.
However, WHO estimates that 54 percent of people with MDR‑TB in 2024 were still not diagnosed or initiated on appropriate treatment, underscoring the need for expanded screening and stronger referral systems.
Eswatini, one of the 30 high‑burden TB countries globally, recorded an estimated TB incidence of 319 per 100,000 people in 2024, including 13 per 100,000 with MDR‑TB, according to WHO.
The epidemic is compounded by high HIV prevalence and rising drug‑resistant strains.
JN/APA