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Drug-resistant tuberculosis treatment and pregnancy

21st webinar of the Virtual Medical Consilium (VMC) of the WHO Regional Office for Europe dedicated to the DR-TB treatment and pregnancy, held on April 14th, 2023. The webinar agenda includes: • Welcoming remarks. Dr Askar Yedilbayev, Team Lead (TB), Mr Oleksandr Korotych, Technical Officer, Joint Infectious Diseases Unit, WHO Regional Office for Europe, Denmark. • Key principles of management of drug-resistant tuberculosis in pregnant and peripartum people, Dr Jenifer Furin, Harvard Medical School, Department of Global Health and Social Medicine, The Sentinel Project on Paediatric Drug-Resistant Tuberculosis. • Bedaquiline exposure in pregnancy and breastfeeding in women with rifampicin-resistant tuberculosis. Dr Marian Loveday, senior specialist scientist in the HIV and other Infectious Diseases Research Unit at the South African Medical Research Council, South Africa. • Experience of Tajikistan in treatment with modified shorter RR-TB regimen during pregnancy. Dr Firuza Saidova, researcher, Tajikistan. • Questions and Answers. VMC background: As a part of the transition to the latest World Health Organization (WHO) Policy Guidance on drug-resistant tuberculosis (TB), the WHO Regional Office for Europe, via the European TB Research Initiative (ERI-TB) which has been promoting TB research in Member States since 2016, launched the regional operational research on the introduction of the fully oral modified shorter treatment regimens (mSTR) for rifampicin- and multidrug-resistant TB (MDR/RR-TB). The objectives of the project are: to improve treatment success rates for MDR/RR-TB; to facilitate the introduction of all-oral mSTR for patients with MDR/RR-TB under operational research conditions; to foster good clinical care for patients with MDR/RR-TB through operational research; to build and strengthen the research capacity in countries; and to contribute to the global knowledge on the effectiveness and safety of all-oral mSTR for MDR/RR-TB and to provide a basis for future recommendations by WHO. The master protocol of the regional operational research on the introduction of mSTR for MDR/RR-TB was approved by the WHO Ethics Review Committee (WHO ERC) at the beginning of July 2020. A total of 14 WHO European Region countries (Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Republic of Moldova, Romania, Tajikistan, Turkmenistan, Ukraine and Uzbekistan) had joined the initiative by June 2021. The first patients were enrolled into the study in August 2020 in Armenia and, as of February 2023, the regional cohort consists of more than 2800 patients. In September 2020, the WHO Regional Office for Europe, in collaboration with the PAS Centre (Republic of Moldova), launched the mSTR Virtual Medical Consilium (VMC) within the TB REP 2.0 Project. The objectives of the VMC are to support countries to enrol patients on to the mSTR operational research, provide expert advice and discussions on complicated clinical cases, provide guidance on treatment adjustment/discontinuation according to the study protocol, contribute to the further strengthening of clinical and programmatic capacity and to foster good clinical care in the Region.