The BPaLM regimen—Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin—is a game-changer in the treatment of multidrug-resistant tuberculosis (MDR-TB) in India. Success, however, will depend on overcoming high expenses, supply chain issues, and accessibility challenges as the nation aims to eliminate TB by 2025.

Key HighlightsAdvantages of BPaLM Regimen

• Reduces the duration of MDR-TB treatment from 18-24 months to six months.

• All-oral, highly effective regimen with fewer adverse effects and better patient compliance.

• High cure rate of over 90% with reduced pill burden and enhanced cost-effectiveness.

Challenges in Implementation

• High cost and regulatory barriers restricting access in low-resource settings.

• Risk of misuse with faster drug resistance.

• Weaknesses in the supply chain, particularly in rural and high-prevalence areas.

Statements from Leaders or Officials
Dr. Lancelot Pinto, Consultant Pulmonologist, P. D. Hinduja Hospital:
"The BPaLM regimen is short, all-oral, and patient-friendly. It has a high success rate but will only meaningfully impact if access and supply are assured."

• Dr. Mrinal Sircar, Director of Pulmonology, Fortis Hospital:

"BPaLM improves adherence, minimizes side effects, and is in line with India's 2025 target of ending TB."

• V R Raman, Public Health Expert:

"Supply chain consistency and differentiated strategies for vulnerable patient groups are critical to the success of BPaLM."

• Dr. Sandeep Jain, Consultant Pulmonologist, Neotia Mediplus:

"BPaLM has yielded encouraging results, but actual community-level impact will hinge on rapid rollout and infrastructure preparedness."
While BPaLM offers a revolutionary treatment for MDR-TB, its success in real life is insisted upon by experts as dependent on strong government initiative. Maintaining unbroken drug supply, expanding universal drug-susceptibility testing, and correcting socioeconomic determinants such as nutrition and poverty are going to be the drivers in converting this potential regimen into a game-changer against TB in India.