One injection instead of months of TB pills? What WHO’s new targets mean for India

New Delhi: Imagine replacing months of medicines with one injection to prevent tuberculosis (TB). For people being treated for active tuberculosis (TB), imagine completing the medication part of treatment with just a few dosing visits instead of taking tablets daily for months. That is the direction the World Health Organisation (WHO) wants future TB medicines to take.

On Wednesday (October 28), WHO published new target regimen profiles for long-acting injectable (LAI) medicines for TB prevention and treatment. The goal is preventive therapy that could ideally be delivered in one injection at a single healthcare visit, and active TB treatment lasting no more than four months with three or fewer dosing encounters.

For India, which carries the world’s largest TB burden, the idea could be a big deal. However, these medicines are not available for routine TB treatment yet. WHO has essentially laid out what researchers and drug developers should aim for.

Why is WHO looking at long-acting TB injections?

TB treatment works only when the correct medicines are taken for the prescribed duration. That can mean following a daily medication schedule for months. A person may have to travel to a health facility, take time off work, manage side effects and remember medication while dealing with the illness itself. For families already struggling financially, repeated healthcare visits can add another layer of difficulty.

Some of this burden may be reduced by long-acting formulations. These drugs are made to release the active ingredients slowly so you can keep therapeutic levels of the drug for longer periods and don’t have to take a tablet each day. Long-acting medicines are not a completely new concept. Similar approaches are already used in areas including contraception, mental healthcare and HIV prevention and treatment. Now, researchers are exploring whether the technology can make TB care easier too.

One injection for TB prevention?

For TB preventive treatment, WHO’s optimal target is an entire course delivered through one injection during one healthcare encounter. Preventive treatment is different from treating active TB. It can be offered to eligible people with TB infection who do not have active disease but are at risk of developing it.

For active TB disease, meanwhile, WHO wants future long-acting regimens to last no longer than four months and involve a maximum of three dosing encounters.

Why could this matter so much for India?

India accounted for nearly a quarter of the world’s estimated TB cases in 2024, according to the WHO’s Global Tuberculosis Report 2025. That means even a fairly simple change in how treatment is delivered could potentially impact an enormous number of people. It may be easier to fit fewer doses around work, studies and family commitments. Fewer trips to the healthcare facility could also mean less money spent on travel and less time away from work.

There may be an added benefit: adherence. Not taking doses or stopping TB treatment too early can impact recovery and cause drug resistance. A medicine that remains active for longer could reduce the number of opportunities to miss a daily dose. People would still need timely diagnosis, appropriate testing, clinical monitoring and access to healthcare. Nutrition, co-existing illnesses and social and economic barriers to treatment would continue to matter.

Could you get these TB injections today?

No.

The organisation has released target profiles, not a recommendation telling doctors to replace existing TB medicines with a new injectable regimen. Candidate long-acting TB medicines still need to go through clinical development and trials to establish whether they are safe and effective. Regulatory approvals would then be required before they could enter routine healthcare.

WHO also wants future formulations to be practical in real-world settings. Its targets include small injection volumes, administration at lower levels of the healthcare system and, importantly, formulations that ideally do not depend on refrigeration.

For a country as large and geographically diverse as India, avoiding complicated cold-chain requirements could make eventual distribution considerably easier. Affordability will be another major question. A breakthrough treatment has limited public-health value if the people who need it cannot access it.

What happens to TB treatment now?

For now, nothing changes for patients already receiving TB treatment. People should continue taking medicines exactly as prescribed and should not stop tablets or look for unapproved injectable alternatives because of reports about the WHO targets.

If clinical trials eventually show that long-acting injections can safely deliver comparable results with dramatically fewer doses, TB treatment could become much less demanding for patients. WHO now wants researchers to find out whether that future can actually become reality.

Disclaimer: This article is intended for informational purposes only and should not be considered medical advice. People undergoing treatment for tuberculosis should not stop or modify prescribed medication without consulting a qualified healthcare professional.