Case Studies & Testimonials
Stories of PeerLINC’s impact, plus participants on their experiences and the impacts of the PeerLINC model
BRAZIL
Case Study: Brazil Builds Momentum for DR-TB Treatment with PeerLINC Support
While Brazil is a high TB burden country, its burden is predominantly for drug-sensitive TB. Consequently, there was a lack of specific technical assistance (TA) and broad experience in using short-course DR-TB treatments. No TA provider was available to work with Brazil to implement new treatments. Following contact by TB Alliance in March 2024, Brazil agreed to implement new treatments, and the procurement process commenced.
A delegation of eight participants was sent to Manila to participate in a "training of trainers" in August 2024, timed to occur shortly before the arrival of new medicines in Brazil in October. As per the country's request, the training offered various DR-TB treatment options based on the latest WHO guidelines, in addition to BPaL/M. A country implementation plan was developed, and Brazil is working with TB Alliance to enable timely BPaL/M implementation. The first person received BPaL/M in December 2024 due to a delay in the supply of medicines. The scale-up is now ongoing.
Testimonial
“Amazing how the Department of Health (Philippines) is very supportive in the programs for tuberculosis. We don’t get many opportunities for assistance from outside. The PeerLINC training was a good experience to discuss with another country, other clinicians with different lead experiences, and we learned many new things. We will implement these ideas back home!”
- Dr. Fernanda Dockhorrn, Director, National Tuberculosis Program, Brazil
Key Outcomes of PeerLINC participation
Scheduled delivery of medicines
Planning to immediately implement all drug-resistant TB patients on new regimen
DEMOCRATIC REPUBLIC OF CONGO
Testimonial
“The DRC really appreciated the activity organized by PeerLINC in the Philippines, which was in the form of experience sharing rather than a training itself. The exchanges on what is being done in the Philippines and the return of the DRC have allowed us to better understand things, rather than receiving everything as training data and having difficulties in implementation when returning from a country.”
- Dr. Sissy Musala N’kas, Assistant to Head of Division of National Reference Laboratory for Mycobacteria, Democratic Republic of Congo
Key Outcomes of PeerLINC participation
Plans to pursue a cost effectiveness analysis
NIGERIA
Case Study: Scaling BPaL/M in Nigeria with PeerLINC Support
An international TA provider, with USAID funding, conducted operations research for BPaL in Nigeria from 2021 to 2023. Although Nigeria was keen to roll out BPaL/M nationally, the TA provider did not offer training or capacity-building support. Consequently, sites beyond those involved in the operations research were unfamiliar with implementing BPaL/M. Despite having already purchased the medicines, Nigeria faced challenges in implementation. This concern was raised in a discussion with TB Alliance in March 2024.
PeerLINC conducted training for 63 physicians and lab specialists in Abuja in July 2024. TB Alliance secured co-funding for the program from partners, which was significantly lower than estimates from international TA providers. As of now, Nigeria is actively scaling up the implementation of BPaL/M, with ongoing efforts to ensure widespread adoption and effective treatment outcomes.
Testimonial
“The training included highly detailed clinical and practical sessions, delivered in a simple, easily understandable way. This is one of the best methodologies for adult training I have experienced. Additionally, adequate material resources were shared for further learning and rooms were created for further follow up, technical support, and interactions.”
- Dr. Clement Adesigbin, MDR-TB Lead, National TB Program, Nigeria
Key Outcomes of PeerLINC participation
Step-down training schedule for two states
Formation of clinical expert council
PAPUA NEW GUINEA
Case Study: PeerLINC Catalyzes Guideline Reform in Papua New Guinea
Papua New Guinea last revised their DR-TB treatment guidelines in 2017 to include a newly introduced longer treatment regimen. Since then, several updates in TB care recommended by WHO were not incorporated into the country's guidelines. PeerLINC conducted its pilot training with Papua New Guinea (PNG) in September 2023 in Manila, leading to the implementation of BPaL/M in December 2024. The revised guidelines included not only BPaL/M but also short-course treatment for pediatric TB. This was particularly noteworthy, as many TA partners had previously given up on revising and updating guidelines in PNG.
PERU
Case Study: PeerLINC Supports Peru’s Path to Nationally Implement New DR-TB Treatments
Peru was the first country trained by PeerLINC in April 2024, just one week after the program's launch. Peru had expressed interest to TB Alliance for training and capacity building in late 2023. At that time, PeerLINC was in its pilot phase, and a third-party TA provider working with the National TB Program (NTP) was guiding the program to conduct operations research. While TB Alliance made BPaL/M drugs available in Peru in early 2024 through a donation by a local non-profit, and the country began providing limited access, it was the PeerLINC training in April 2024 that catalyzed rapid uptake.
A group of experts and trainers from the NTP participated in a week-long program in Manila, which included visits to TB hospitals and labs, and workshops with PeerLINC and TB Alliance to develop an implementation plan. Following their return to Peru, collaboration continued developing national clinical guidelines for BPaL/M and the inclusion of pretomanid in the Essential Medicines List (EML). These updates were completed within months, paving the way for broader programmatic implementation.
As of May 2025, just over a year since Peru participated in PeerLINC training, BPaL/M regimens have reached nearly a thousand Peruvians. Treatment success rates have risen from ~60% to ~90%, and treatment dropout rates have fallen from 25% to 7%.
Testimonial
“The PeerLINC training experience was great and it covered all aspects of DR-TB treatment, including clinical as well as structure and operation of laboratory services, which will be very useful for updating the processes in Peru’s programs. We plan to continue working with the PeerLINC team for further work in our country, including updating EML, and roll-out of BPaL/M regimens.”
- Feedback from anonymized post-training evaluation form
Key Outcomes of PeerLINC participation
Updating of Essential Medicines List
Updating of national clinical guidelines
Planning for sub-national capacity building
RWANDA
Case Study: Rwanda’s Rapid Update of TB Guidelines with PeerLINC
Rwanda initially expressed interest in revising their TB guidelines in November 2023, but this work was put on hold due to a lack of local capacity. In April 2024, anticipating the approval of pretomanid in May 2024, the National TB Program confirmed the need for assistance. PeerLINC promptly mobilized to provide support, updating the national clinical guidelines just two weeks after the official request. The government of Rwanda formally approved the revised guidelines within two months (June 2024), and associated training was provided to clinical, programmatic, and laboratory specialists
Testimonial
“PeerLINC training facilitators have strong experience and well prepared training materials. Rwanda’s National TB Program has been delighted by the professional work, contribution, and experience of PeerLINC in updating our national DR-TB guidelines”
- Dr Yves Habimana-Mucyo, Director of MDR-TB Unit, Rwanda
Key Outcomes of PeerLINC participation
Approval of national clinical guidelines
Support of “training the trainers” program planning