Frontline Healthcare Providers in the Philippines
Assert the High Acceptability of the BPAL Regimen

Left to right (from top to bottom):  Dr Nancy Navarete (Physician, SMMGHHSC), Ms Lovely Ducusin (Clinic Nurse, ITRMC), Dr Alimar Nassaie (Physician, ECSGH), Dr Melissa Abado (Physician, ITRMC) and Mr Carlo Ryan Estopace (Clinic Nurse, SMMGHHSC) – Photo credit:  TB People Philippines video-interview

In May 2021, the BPaL regimen, a novel six-month-treatment which combines Bedaquiline (B), Pretomanid (Pa) and Linezolid (L) for multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB was officially implemented as an operational research (OR) in the country.  Conventionally, MDR and XDR-TB treatment would take 18 months or longer with very low success rates and with high prevalence of adverse events. The BPaL OR was set out to estimate the effectiveness and safety of the new short all-oral regimen.

Now on its tenth month of implementation, the OR has successfully graduated 9 patients and continues to observe better quality of life among its enrollees. “I strongly recommend that they (patients) be enrolled in the (BPaL) regimen. Aside from the fact that this (BPaL regimen) offers lesser pills and lesser duration of treatment, this presents lesser adverse drug reactions (ADRs), and rest assured that these ADRs are easily managed”, attests Dr Alimar Nassaie (Physician at Eversley Childs Sanitarium and General Hospital, one of the 12 OR sites).  Ms Lovely Ducusin (Clinic Nurse at the Ilocos Training and Regional Medical Center – ITRMC, also one of the OR sites) further testifies, “(It’s) easier to manage…kaunti lang ang ADRs na nararamdaman ng patients kung ikukumpara mo sa regular patients under PMDT; kaunti lang ang complaints ng patients […there are fewer ADRs experienced by patients (on BPaL) compared to the regular patients under programmatic conditions; there are few complaints from (BPaL) patients.]  These statements are echoed by all healthcare providers in the video-interview by TB People Philippines further providing grassroot evidence on the high acceptability of the BPaL regimen.

Dr Melissa Munar-Abado (ITRMC Physician) says, “Psychologically, advantageous sa pasyente, kaunti na lang yung iniinom; mas madali nilang ma-tolerate yung pag-inom. [Psychologically, it’s advantageous to the patients since there is lesser intake of drugs; therefore, it is easier for them to tolerate the treatment]. On this front, many of the patient graduates expressed much appreciation for the fast recovery accorded by the BPaL regimen, and gratitude to the healthcare providers who have managed their treatment. In the process, they have developed a sense of advocacy in providing peer support to patients who are now contemplating on their MDR-TB treatment journey.

The BPaL OR promises to provide faster treatment for MDR- and XDR-TB patients with higher likelihood of success through the concerted and competent efforts of frontline healthcare providers.

*We would like to extend our sincere gratitude to all healthcare workers from the OR sites for their unwavering support, hard work and commitment in managing the BPaL OR patients.  We would also like to express our utmost thanks to TB People Philippines for providing the video testimonials in this article.

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