One Injection for TB Prevention? WHO Sets Targets to Ease Burden of Daily Treatment

WHO’s target regimen profiles cover preventive treatment and treatment for people with TB disease, with separate expectations for each purpose.

The World Health Organization has published development targets for long-acting tuberculosis injections that could reduce the need to take daily medicines over several months. Keeping up with lengthy oral regimens can be difficult for people receiving TB care, creating a need for options that fit more easily into their lives. The new profiles describe what future injectable regimens would need to deliver for TB prevention and treatment to become practical choices.

Long-acting injectables have changed the management of other conditions, most visibly HIV, and several candidates for TB are entering or approaching clinical development. Their potential lies in reducing the daily demands of taking medicines and changing how health services organise and deliver care. The profiles give developers an early guide to the effectiveness, safety and convenience required for these medicines to make a useful difference.

WHO's target regimen profiles cover preventive treatment and treatment for people with TB disease, with separate expectations for each purpose. Every characteristic has a minimum requirement that makes a product worth pursuing and an optimal target considered desirable and realistically achievable. The document is intended for pharmaceutical companies, universities, research institutions, product development partners, TB-affected communities, civil society organisations and donors.

Fewer dosing visits could ease the treatment burden

For TB preventive treatment, the profile sets a target of completing the entire course through a single injection during one healthcare encounter. For TB disease, it describes a regimen lasting no more than four months, delivered through three or fewer dosing encounters. These are targets for medicines under development, with future candidates needing evidence that they can deliver the expected benefits.

Both profiles call for small injection volumes and administration by trained health workers at the lowest feasible level of the health system. Products should require no cold chain, reducing the storage and transport demands associated with medicines that need continuous refrigeration. Their effectiveness and safety must be at least as good as those of current oral regimens, making convenience one part of a broader set of requirements.

Development must account for affordability and everyday care

Dr Tereza Kasaeva, Director of WHO's Department for HIV, Tuberculosis, Hepatitis and Sexually Transmitted Infections, said long-acting injections could make TB prevention and treatment much simpler for people who need them. She explained that the profiles tell developers early what a regimen must achieve to make a practical difference without sacrificing effectiveness, safety or patient choice. That approach weighs the treatment experience alongside a new medicine's clinical performance.

The document examines trade-offs between product characteristics and considers trial design, the overall burden of treatment and the ability to deliver new regimens at scale. It includes equitable access, transparent pricing, and cost because a medicine's usefulness depends on whether people and health services can obtain and afford it. Developers are being asked to consider those practical demands as part of product development from the outset.

Community evidence shapes the targets and protects choice

WHO convened a Scientific TRP Development Group that brought together clinical trial specialists, pharmacologists, regulators and national TB programme officers. People with lived experience of TB and civil society representatives contributed to the profiles, bringing perspectives from those directly affected by treatment decisions. The group drew on a landscape analysis, public consultation held in April and May 2026, community and provider surveys, focus group discussions and a multicountry experiment examining preferences between treatment options.

Development of better oral regimens should continue alongside work on injections, preserving alternatives for people who prefer taking medicines by mouth. Introducing long-acting products should expand the available options and preserve each person's ability to choose their treatment. The profiles establish expectations for future regimens that combine fewer dosing encounters with reliable clinical performance, practical delivery and access.