)
Tuberculosis (TB) treatment could become considerably simpler in the coming years, with the World Health Organization (WHO) outlining new targets for long-acting injectable medicines that may reduce the burden of taking daily pills for months.
Currently, most people undergoing treatment for drug-susceptible TB need to follow a combination of medicines every day for several months. Maintaining this routine can be challenging, particularly for people who face financial difficulties, have to travel long distances to healthcare facilities or experience side effects during treatment. Missing doses or interrupting treatment can also compromise outcomes and contribute to drug resistance.
In a significant development, the WHO has released new target regimen profiles for long-acting injectables (LAIs) for both TB prevention and treatment. The proposed approach aims to make preventive treatment possible through a single injection during one healthcare visit, while treatment for active TB could potentially be delivered over no more than four months through three or fewer dosing encounters.
The development is particularly relevant for India, which carries the world's largest TB burden. However, these are targets for future drug development, not treatments currently available to patients. Here's what the WHO's announcement means and why it matters.
What has the WHO announced about long-acting TB injections?
On October 28, 2026, the WHO published its Target Regimen Profiles for Long-Acting Injectables for Tuberculosis Prevention and Treatment. These profiles outline the minimum and optimal characteristics that future injectable TB medicines should meet to be considered useful in clinical practice.
The WHO has identified two distinct goals:
- TB preventive treatment: The entire preventive treatment course should ideally be delivered through a single injection during one healthcare encounter.
- Treatment of active TB disease: The treatment course should last no more than four months and require three or fewer dosing encounters.
The distinction is important. Preventive treatment is intended for people who have TB infection but do not have active TB disease, helping reduce their risk of developing the illness. Treatment regimens, meanwhile, are intended for people diagnosed with active TB.
The proposed injectable medicines are expected to provide effectiveness and safety at least comparable to existing oral treatment options.
READ | AI Can Help Doctors Detect Tuberculosis And Lung Cancer Earlier, Says Former AIIMS Director
How do long-acting injections work?
Long-acting injectables are medicines formulated to release their active ingredients gradually over an extended period. They are generally administered through intramuscular or subcutaneous injections. Unlike conventional medicines that need to be swallowed daily, these formulations are designed to maintain therapeutic drug levels for longer, potentially reducing how frequently a person needs medication.
The technology has already shown potential in other areas of healthcare, including HIV prevention and treatment, schizophrenia, opioid dependence and contraception. For example, long-acting cabotegravir for HIV prevention is administered every two months, while lenacapavir is administered twice yearly for HIV prevention.
The WHO's new profiles seek to encourage similar advances in TB care, where the duration and complexity of treatment can create significant challenges for patients.
However, the TB injectable candidates are still entering or approaching clinical development. Their effectiveness and safety will need to be established through clinical trials before they can be introduced into routine care.
Why could fewer injections make TB treatment easier?
One of the biggest challenges in TB management is ensuring that patients complete the prescribed treatment.
People with TB may need to take multiple medicines daily over several months. This can become particularly difficult for those who work long hours, live far from healthcare facilities or experience medication-related adverse effects.
Long-acting injections could potentially reduce this treatment burden in several ways:
- Improved adherence: Fewer medication-taking occasions could make it easier for patients to complete their treatment.
- Fewer healthcare visits: Reduced dosing frequency could lower travel expenses and the time patients spend away from work.
- Reduced treatment interruptions: A sustained-release formulation could help avoid missed daily doses, although it would not eliminate all causes of treatment interruption.
- Potential reduction in drug resistance: Better treatment adherence could reduce the risk of resistance associated with incomplete or interrupted treatment.
- Reduced treatment-related stigma: Fewer visits and less frequent medication-taking may make treatment easier to manage privately.
However, injections will not independently resolve every challenge associated with TB care. Early diagnosis, appropriate drug-susceptibility testing, nutritional support, management of other illnesses and continued monitoring will remain essential.
READ | Delhi Government To Repurpose 85 TB Testing Machines For Hepatitis B, C Testing
Why is this development particularly important for India?
India accounts for the largest share of the global TB burden, making improvements in treatment delivery particularly important for the country.
According to the WHO's Global Tuberculosis Report 2025, an estimated 10.7 million people developed TB globally in 2024, while approximately 1.23 million died from the disease. India accounted for around 25% of the estimated global TB cases.
The country's National TB Elimination Programme (NTEP) has focused on improving early detection, treatment access, adherence and nutritional support through initiatives such as Ni-kshay.
For many Indian patients, particularly those from economically disadvantaged communities, prolonged treatment can mean repeated travel to healthcare facilities, lost wages and difficulties balancing medication schedules with daily responsibilities.
If long-acting injectables become available, they could potentially make treatment delivery more convenient, particularly in areas where healthcare access is limited. However, their usefulness in India will depend on affordability, availability, healthcare infrastructure and the ability of the public health system to administer and monitor these medicines.
What safety and accessibility requirements has the WHO highlighted?
The WHO's target profiles do not focus on convenience alone. They also specify important requirements for the development of these medicines.
Both preventive and active TB treatment profiles call for:
- Administration by trained healthcare workers at the lowest feasible level of the health system.
- Small injection volumes to make administration more practical.
- Formulations that do not require a cold chain, reducing storage and transportation challenges.
- Safety and effectiveness at least comparable to existing oral treatment regimens.
- Affordability and equitable access, including transparent pricing.
- Clinical trial designs that establish effectiveness and safety in relevant populations.
The cold-chain requirement is particularly relevant for India, where maintaining temperature-controlled storage and transportation can be challenging in remote and underserved regions. The WHO has also emphasised that research into improved oral treatment regimens should continue alongside injectable development.
Patients who prefer oral medicines should retain the option of receiving them. The objective is to expand treatment choices, not replace one approach with another without considering individual needs.
READ | That Small Shadow On The Lung: Why Finding Out Matters
Are long-acting TB injections available in India now?
No. The WHO's announcement establishes development targets rather than recommending an injectable treatment for immediate clinical use. Several candidate medicines are entering or approaching clinical development, but they must undergo clinical testing and regulatory assessment before they can be approved for routine use.
India's existing TB treatment protocols therefore remain applicable. Patients should not stop their prescribed medicines or seek unapproved injectable alternatives based on reports about future treatments. The development of these medicines will also require sustained collaboration between researchers, pharmaceutical companies, regulators, governments and organisations working with people affected by TB.
The WHO's new targets for long-acting injectable TB medicines represent an important step towards making tuberculosis prevention and treatment less burdensome. A single injection for preventive treatment and a maximum of three dosing visits for active TB treatment could eventually change how patients access and complete care.
For India, where millions are affected by TB and treatment adherence remains a major public health priority, such innovations could have considerable implications. However, the proposed regimens are not yet available. Their clinical effectiveness, safety, affordability and suitability for India's healthcare system will determine whether this potential translates into a meaningful improvement in TB care.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.