March 2025
T
aking up to 17 pills a day and receiving constant injections can be exhausting, even when you know your life depends on it. Benito understands this well. At over 60 years old, being diagnosed with multidrug-resistant tuberculosis (MDR-TB) was an emotional blow, but even more so when he was told that the treatment could last up to a year and a half.
“That discouraged me. The pills made me nauseous. My head hurt, and I felt weak,” he recalls. The thought of continuing this for such a long period of time felt overwhelming. However, after a while, the doctors who evaluated him offered an alternative: a shorter, oral treatment that would reduce treatment time to just six months, with fewer visits to the health center, less transportation costs, and fewer concerns.
Benito jumped at the chance. “When they told me I wouldn’t have to take injections anymore and that they would reduce the number of pills, I felt relieved. It’s much easier to follow,” he says, confident that this time the treatment would have fewer side effects. “From then on, I started to improve. I no longer suffered from injection pain. I had less coughing, and I began to gain weight,” says Benito, whose weight had dropped to just 45 kilograms.
Like Benito, around 790 patients in Peru received the MDR-TB treatment regimen from October 2023 to February 2025, according to the Ministry of Health of Peru. Behind each case is a collective effort to improve access to more effective treatments, involving not only the patient but also their families, the community, healthcare workers, and authorities.
“We’ve started to expand molecular diagnosis to the first level of care, as recommended by the World Health Organization (WHO), and are working hard to introduce the best treatment regimens and provide shorter, easier therapy for multidrug-resistant tuberculosis,” explains Valentina Alarcón, Executive Director of Tuberculosis Prevention and Control at Peru’s Ministry of Health. Molecular diagnosis involves advanced laboratory techniques, such as PCR (polymerase chain reaction), which enable faster and more accurate detection and characterization of Mycobacterium tuberculosis (the bacterium responsible for the disease), including drug-resistant strains. “These advances are the result of our work with the Pan American Health Organization (PAHO) and the recommendations they provided in 2023, which the country has adopted and is now implementing.” she adds.
The implementation of these treatment regimens, known as BPaL and BPaLM, has required extensive preparation. Since 2023, doctors, nurses, and monitors—a key figure introduced to track patients—have been trained on the use of the new regimen, its potential side effects, and how to best support patients during their treatment and recovery.
“This has been a challenge for everyone: staying updated and learning about new medications to properly guide and support patients,” acknowledges Dr. Gisselle Aranda, from the tuberculosis program at the "7 de Octubre" Health Center in El Agustino, one of Lima’s most affected districts. “This is a great opportunity for patients to receive effective treatments that are not uncomfortable or painful, significantly reducing side effects,” she says.
The most vulnerable are the most affected
In 2023, according to the Ministry of Health, Peru reported around 33,000 tuberculosis cases, of which around 3,100 were multidrug-resistant, a more difficult-to-treat form of the disease.
By 2025, this landscape is starting to change. The shortened oral treatment is already included in Peru’s National Tuberculosis Plan (PNT), it is free, and it has shown promising results in improving treatment adherence. PAHO/WHO technical cooperation has contributed to making this process sustainable by supporting the training of healthcare staff, facilitating the purchase of medications through PAHO's Strategic Fund, and collaborating on updates to public health policies in the sector.
“It’s crucial to keep working together to end tuberculosis in Peru. Authorities, technical teams, healthcare staff, patients, and their families all play a key role in this collective effort. Only with shared commitment can we move toward a tuberculosis-free future and improve the health and well-being of the entire population,” says Maureen Birmingham, PAHO/WHO representative in the country.
Eliminating tuberculosis, especially multidrug-resistant tuberculosis, remains a challenge both in Peru and the Americas as a whole, where only 2 out of 5 people with the disease have access to treatment. However, changes are taking place at various levels. In December 2024, for example, the Ministry of Health of Peru approved the technical standard for patients receiving shortened treatments, marking one of the first steps in a series of strategic actions aimed at improving the quality of treatment and access to care. In this way, more patients like Benito will have the opportunity to regain their health without it becoming a burden on their lives.
Benito’s case reflects what can be achieved with the new shortened regimens, healthcare worker training, and collective efforts to provide more accessible treatment. Each day, his health improves, and with it, his quality of life. “If you feel bad, just like I did, come to the health center. Don’t let the disease defeat you,” he says confidently. Benito knows that he will soon leave multidrug-resistant tuberculosis behind and recover his health—something the disease could have taken from him without the right treatment.
Tuberculosis, one of the world’s leading infectious disease killers, is one of more than 30 communicable diseases and related conditions that PAHO aims to eliminate by 2030 as part of its Elimination Initiative.
