Drug-resistant tuberculosis is a major health challenge across much of Africa, but a new medicine being pioneered in South Africa could be a breakthrough after decades of frustration.
Bedaquiline is being made available to 3,000 people suffering side effects of the usual drug-resistant tuberculosis treatment, or who have developed complete drug resistance.
The early signs are encouraging, doctors say, though bedaquiline hasn't yet been tested in large-scale clinical trials.
The new drug—one of the first new tuberculosis antibiotics released in 40 years—was first given to 217 South African patients as part of an early access programme.
Jennifer Hughes, a 36-year-old British doctor in Cape Town, said she has seen the benefits.
Already, word has spread at Hughes's clinic in Khayelitsha, a poor township, and people are coming from all over the city requesting the new drug, developed by US-based pharmaceutical company Janssen.
"Everyone has heard that this is where you get better treatment," said Hughes, who recalls the "really, really happy day" when her first bedaquiline patient was declared tuberculosis-free in November last year.
South Africa has one of the worst tuberculosis epidemics in the world, with more than 1,000 cases per 100,000 people and the department of health describing the rise of drug-resistant tuberculosis as a "major public health problem."
"We want to get 3,000 patients on bedaquiline this year, and plans are in place to scale up," said Norbert Ndjeka, South Africa's director of the drug-resistant tuberculosis programme.
"The drugs are already in a number of our facilities. Definitely these drugs will reach the patients."
The treatment is also being used in Russia and has received conditional guidelines from the World Health Organization (WHO).
But clinical trials aren't concluded, and the drug can be prohibitively expensive—factors that have limited its distribution.