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One injection instead of months of daily pills: the bar WHO has just set for TB

Qurexa Editorial Team29 October 20267 min read 0 0
One injection instead of months of daily pills: the bar WHO has just set for TB

What happened

On 28 October 2026, the World Health Organization (WHO) published a document called Target regimen profiles for long-acting injectables for tuberculosis prevention and treatment. The name is a mouthful, but the idea is simple. A target regimen profile, or TRP, is a specification. It tells drug companies what a new medicine must be able to do before it is worth developing at all. For each feature, WHO sets two levels: a minimal requirement, which is the least a product needs to achieve to be useful, and an optimal requirement, which is the best that is realistically achievable. The headline targets are striking. For preventing TB, WHO wants a full course of treatment delivered as a single injection, at one appointment. For treating active TB disease, it wants a regimen lasting no more than four months, given in three or fewer dosing appointments. WHO set other conditions too. The injection should be given by a trained health worker at the lowest practical level of the health system, so people do not have to travel to a specialist hospital. The injection volume should be small. It should not need cold chain storage, which means no refrigeration between factory and patient. And it must be at least as safe and as effective as the tablets people take today. Dr Tereza Kasaeva, Director of the WHO Department for HIV, Tuberculosis, Hepatitis and Sexually Transmitted Infections, said long-acting injectables "could make TB prevention and treatment much simpler for the people who need them". She added that the profiles tell developers early on what a regimen must achieve, without sacrificing how well it works, how safe it is, or patient choice.

Why this matters

Tuberculosis is a bacterial infection that usually attacks the lungs. It is still one of the world's deadliest infectious diseases. WHO's Global tuberculosis report 2025 estimated that TB caused about 1.23 million deaths in 2024. That figure includes 1.08 million deaths among people who did not have HIV, and 150,000 among people living with HIV. An estimated 10.7 million people fell ill with TB that year. Here is the part that explains why WHO is interested in injections. TB prevention and treatment still rely on daily tablets taken for months at a time. That is a long time to take medicine every single day, and many people struggle to keep going. Life gets in the way. Side effects bite. Clinics are far away. People start to feel better and assume they are cured. When a course is not finished, two things can happen. The infection can come back. And the bacteria that survive can become resistant to the drugs, which makes the next round of treatment harder, longer and more expensive. This is not a new problem, and it is not unique to TB. It is the single biggest reason a good medicine can fail a patient. Anything that turns months of daily doses into one or two appointments would change the arithmetic completely.

What the evidence actually says

It is worth being clear about what this announcement is, and what it is not. WHO has not approved a new TB injection. There is no long-acting TB injectable licensed for use anywhere today. What WHO has published is a specification for medicines that do not exist yet. It is a target, not a product. That said, the target is not wishful thinking. WHO says several long-acting injectable TB candidates are entering or nearing clinical development. And the approach already has a track record in a different disease: long-acting injectables have changed HIV care, replacing daily tablets for some patients. The profiles were not written by WHO alone. WHO convened a Scientific TRP Development Group that included trialists, pharmacologists, regulators, national TB programme officers, people with lived experience of TB, and civil society representatives. The work drew on a landscape analysis, a public consultation held in April and May 2026, surveys of communities and providers, focus group discussions, and a multi-country discrete choice experiment, which is a method for working out which trade-offs people actually prefer. Two caveats in WHO's own document deserve attention. First, WHO says work on better oral regimens should carry on in parallel, because some people would simply rather not have injections. Second, it says any rollout must preserve patient choice. The profiles also cover trial design, treatment burden, how easily a product could be scaled up, equitable access, transparent pricing and cost. In other words, WHO is trying to avoid inventing something brilliant that poorer countries cannot afford.

Qurexa perspective

We will be honest about the connection here, because it is a real one rather than a stretch. Qurexa delivers prescriptions and supports medication adherence, which is the plain-English business of helping people actually take the medicine they have been prescribed. TB is not something we handle, and most people reading this in Lincolnshire will never need TB treatment. But the problem WHO is describing is one we see constantly. A long course of daily tablets is hard to finish. People miss doses when their routine changes, when a repeat prescription runs out at an awkward moment, or when they cannot easily get to a pharmacy. The medicine was never the weak link. The month-after-month taking of it was. That is why this WHO document interests us. It treats adherence as a design problem to be solved by the medicine itself, not as a failing of the patient. We think that is the right way round.

Practical advice

You cannot ask for a long-acting TB injection, because none exists yet. But the thinking behind it is useful for anyone on a long course of medicine. Finish the course unless you are told otherwise. Feeling better is not the same as being cured. With infections in particular, stopping early can let the illness return in a harder-to-treat form. Never stop or change a prescribed medicine on your own. If side effects are making a course unbearable, that is a reason to speak to your prescriber, not a reason to quietly stop. There is often an alternative dose, a different drug, or something that helps with the side effect. Use your pharmacist. Pharmacists are medicines experts and you do not need an appointment. They can explain what a medicine does, what to do about a missed dose, and whether anything you are taking clashes. Make the routine easier than remembering. Pair your dose with something you already do every day, such as brushing your teeth. Use a pill organiser, a phone alarm, or a repeat prescription service so you are not relying on willpower. Sort out repeats before you run out. Order with several days to spare, especially around bank holidays and before travel. A gap in supply is one of the most common reasons a course gets broken. If you have a cough that will not go away, or you are losing weight, sweating at night or running a fever without explanation, see your GP. These can have many causes, and most are not TB. But they are worth a professional opinion rather than a search engine.

What to know

WHO has published the first target specifications for long-acting injectable TB medicines. It wants TB prevention delivered in a single injection, and TB treatment cut to four months or less in three appointments or fewer, with no refrigeration needed and safety and effectiveness at least matching today's tablets. No such medicine exists yet. This is a brief handed to drug developers, built with trialists, regulators, national TB programmes, people who have had TB and civil society. Several candidates are entering clinical development, and the model has already worked in HIV care. The reason any of this matters is simple. TB killed an estimated 1.23 million people in 2024, and treatment still depends on taking tablets every day for months. Making the medicine easier to take is not a convenience. It is a way of making it work. Sources: World Health Organization, "WHO releases target regimen profiles for long-acting injectables for TB", 28 October 2026, https://www.who.int/news/item/28-10-2026-who-releases-target-regimen-profiles-for-long-acting-injectables-for-tb; World Health Organization, "Global tuberculosis report 2025 – TB mortality", 2025, https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2025/tb-disease-burden/1-2-tb-mortality. This article is for general information and does not replace advice from a doctor, pharmacist or other qualified healthcare professional.

#tuberculosis#WHO#global health#medication adherence#new treatments#public health

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