Patients in low- and middle- income countries are very willing to try long-acting tuberculosis preventative injectables
A new LONGEVITY project article has been published highlighting the willingness of patients in low- and middle- income countries to try long-acting preventative therapies for tuberculosis (TB).
Over 400 patients from India and South Africa, many with experience of tuberculosis prevention therapies, were surveyed in person. Of these patients, 75% expressed strong willingness to try long-acting TB preventative injectables.
43% of health care providers surveyed in low- and middle- income countries favoured long-acting injectable TB prevention therapy. Injectable preference was followed then by pills, implants and microarray patches. 43% made long-acting injectables the preferred option of those given, but health care providers have concerns around the cost implications of injections.
The main takeaway from this paper is the highlight that the vast majority of patients with experience of TB prevention medications want to try long-acting injection versions of them. South Africa and India were chosen for survey as they are low- and middle- income countries with a high tuberculosis prevalence and death toll.
According to the World Health Organisation, around 1.25 million people died from TB in 2023. Last year, TB took over from COVID-19 to become the world’s biggest single infection killer again. A paper from Berida and Lindsley states that TB is the deadliest disease in recorded history.
The majority of cases and a large proportion of TB deaths are in low- and middle- income countries. Over two thirds of 2023’s total TB cases were in Bangladesh, China, Democratic Republic of the Congo, India, Indonesia, Nigeria, Pakistan and the Philippines.
The research is part of the LONGEVITY project, funded by global health agency Unitaid. LONGEVITY is a flagship project within the Centre of Excellence of Long-acting Therapeutics (CELT). We work to take existing tuberculosis, malaria and hepatitis C virus medications, that are safe and effective, and create long-acting versions of them that we hope will be transformational in low- and middle- income countries.
LONGEVITY is an international consortium of varied disciplines and expertise to cover all the steps from concept, research, manufacture and dissemination. This includes organisations who oversee licensing, and partners like University of Nebraska Medical Center and Treatment Action Group (TAG) who are critical to our community engagement activities.
The paper is titled ‘Patient and provider preferences for long-acting tuberculosis preventive therapy’. It is an open-source article published in the International Journal of Tuberculosis and Lung Diseases.
Prof. Andrew Owen who leads the LONGEVITY project and is co-Director for CELT said
The University of Nebraska Medical Center and TAG’s work is critical to our understanding the role that long-acting therapeutics may play in the future, and their expected impacts for patients in low- and middle- income countries. This paper is a big step towards reassuring us that the outcome of our work will help towards the WHO goal to eradicate TB by 2030.
Dr, Marcia Vermeulen is a Medical Officer at the University of Cape Town in South Africa and implemented the patient surveys there. She presented the results at the Conference on Retroviruses and Opportunistic Infections (CROI) in San Francisco in March 2025, and you can see the abstract on the CROI 2025 abstract page. Dr. Vermeulen said
The LONGEVITY TB prevention survey provided an opportunity for both patients and providers to express their preferences regarding potential long-acting modalities. This highlights the importance of facilitating such opportunities, as it demonstrates that patient and provider input is valued and plays a critical role in guiding the development of these modalities.
The authors from LONGEVITY organisations represent University of Nebraska Medical Center, Treatment Action Group, Johns Hopkins University School of Medicine and the Centre of Excellence for Long-acting Therapeutics.
There are more LONGEVITY publications lists on the LONGEVITY project publications page.
References
Berida, T., & Lindsley, C.W. (2024). Move over COVID, tuberculosis is once again the leading cause of death from a single infectious disease. Journal of Medicinal Chemistry, 67(24).
Vermeulen, M., Scarsi, K.K., Furl, R., Sayles, H., Anderson, M.J., Valawalkar, S., Kadam, A., Cox, S.R., Mave, V., Barthwal, M., Schutz, C., Ward, A., Dountio Ofimboudem, J., Meintjes, G., Rannard, S., Owen, A., & Swindells, S. (2025). Patient and provider preferences for long-acting tuberculosis preventive therapy. International Journal of Tuberculosis and Lung Diseases, 2(5).
LONGEVITY
Sign up to the quarterly LONGEVITY project newsletter mailing list to make sure you don't miss key pieces of news like this.
The LONGEVITY project aims to simplify tuberculosis, malaria and hepatitis C virus treatment and preventative treatment to reduce the drug burden and the number of patients requiring complex therapies for active disease.
Find out more on the LONGEVITY project homepage.
Watch our video to find out more about the LONGEVITY Project
Funder and partners
The LONGEVITY Project is funded by global health agency Unitaid.
The project also involves critical partners and collaborators in CELT, Clinton Health Access Initiative, Johns Hopkins University, Medicines Patent Pool, Queens University Belfast, Tandem Nano Ltd., Treatment Action Group and the University of Nebraska Medical Center.
