Multi-month dispensing of tuberculosis medications in sub-Saharan Africa: A feasible, person-centered care model

Abstract

The treatment success rate among people with tuberculosis in sub-Saharan Africa is suboptimal despite the availability of shortened and efficacious TB regimens. Barriers such as long travel distances and frequent clinic visits for medication refills hinder access to care and compromise treatment adherence and completion. Multi-month dispensing of anti-retroviral drugs has proved successful in improving treatment adherence and viral load suppression among people living with human immunodeficiency virus. The strategy could be adapted for tuberculosis care to address treatment access and adherence barriers to optimize treatment success. In this perspective, we discuss the key considerations for the multi-month dispensing of tuberculosis drugs in sub-Saharan Africa. In particular, we highlight treatment monitoring, strengthening of logistics and supply chain systems, multi-month dispensing protocols, healthcare provider capacity building, community engagement, and monitoring and evaluation framework. We call for research, policy reforms, and pilot programs to evaluate and scale up multi-month dispensing of tuberculosis medications to end the epidemic by 2035.