Laboratory strengthening strategies to advance drug susceptibility testing for BPaL regimens in TB treatment

Public Health Action. 2025 Dec 3;15(4):145-148. doi: 10.5588/pha.25.0014. eCollection 2025 Dec.

Abstract

Background: To support BPaL (bedaquiline [Bdq], pretomanid [Pa] and linezolid [Lzd]) rollout, countries require ongoing technical and policy support for standardized drug susceptibility testing (DST).

Methods: The Leveraging Innovation for the Faster Treatment of Tuberculosis (LIFT-TB) operational research project aimed to strengthen laboratory capacity for DST in 7 countries (the Philippines, Myanmar, Indonesia, Vietnam, Uzbekistan, Kyrgyzstan and Ukraine) through needs assessments, reagent and equipment support, quality control and training.

Results: During the project, we trained 157 professionals in phenotypic and molecular DST, enhancing quality assurance and implementation. We found there was variable DST capacity and resistance patterns.

Conclusion: Our study highlights the need for continued investment in training and infrastructure to integrate DST into routine diagnostics and to support scale-up of BPaL regimens in high TB-burden settings.

Keywords: DST; Indonesia; Kyrgyzstan; LIFT-TB; Myanmar; The Philippines; Ukraine; Uzbekistan; Vietnam; drug-resistant tuberculosis; tuberculosis.