Mozambique has a population of 32 million people and in 2022 reported a total of 4,800 DR-TB cases. Total cases of TB reported by 2022 rose to 116,000, and deaths up to 14,000. Although there has been a steady increase in the number of cases reported in the last years, the gap to the estimated WHO incidence is still very big.

Delay times between diagnosis and treatment start are significant, with some diagnosed patients getting lost before they start treatment. Phenotypic drug susceptibity testing (DST) is done only in three reference labs in the whole country. However, the introduction of 10-color Xpert modules in the Global Fund cycle 2024-2026, capable to detect TB resistance to 1st and 2nd line drugs, is expected to improve this situation.

In 2021-2022, a pilot study using short BPaL regime was conducted by the National TB Program (NTP). However, no results have been published yet. In any case, a new DR-TB management policy has been developed by the NTP including BPaL and BPaL(M ) or (L).  BPaL was not included in new Global Fund application and the Global Fund is pushing for this to also be included, but it is foreseen to take some time. At the moment, the country is having a stock of Levofloxacin which they aimed to use prior to the implementation of BPaL(M). The development of training materials and training process is conducted after completed and approved guidelines.

Mozambique is at the early stage of planning and preparation of the programmatic implementation of the shorter DR-TB treatment regimen. The country will benefit from a full comprehensive package of care and roadmap development to effectively implement the shorter regimens.