JOHANNESBURG – In a bold leap against one of humanity’s oldest foes, postdoctoral researcher Dr. Lindokuhle Ngema at the University of the Witwatersrand (Wits) is revolutionizing tuberculosis (TB) treatment with an innovative inhalable nanomedicine.

Developed at the Wits Advanced Drug Delivery Platform (WADDP), this cutting-edge nanosystem delivers all four standard TB drugs directly to the lungs – the hidden stronghold of Mycobacterium tuberculosis. By bypassing the liver and bloodstream, it slashes drug loss, boosts local concentrations, and promises shorter, simpler therapy.

“TB is clever,” Ngema told Wits News. “It hides in lung pockets where oral drugs can’t reach. Our system is designed to be smarter and to go exactly where it’s needed.”

Battling an Ancient Killer in Modern Times

TB has plagued humans for 9,000 years, yet it kills 1.8 million people annually worldwide, with 10 million new infections each year. In South Africa, it claimed over 56,000 lives in 2023 alone. The disease spreads invisibly through coughs and sneezes, and while the BCG vaccine offers early protection, it fades by adulthood.

The World Health Organization’s End TB Strategy demands drastic cuts: 80% fewer cases and 90% fewer deaths by 2030. But current oral regimens – rifampicin, isoniazid, ethambutol, and pyrazinamide taken for six grueling months – breed non-adherence, side effects like liver damage, and deadly drug-resistant strains.

Enter inhalation therapy: a game-changer that targets the respiratory tract, from bronchi to alveoli, for faster relief and better compliance.

The Nanotech Edge

At the heart of Ngema’s breakthrough is a biocompatible nanoparticle “carrier” – a molecular marvel that encapsulates all four drugs in one dose. Inhaled as a powder, it journeys deep into the lungs, releasing medication precisely at infection sites. Non-toxic and body-friendly, it’s engineered to respond to lung conditions, ensuring controlled, on-demand delivery.

Collaboration with the Nuclear Medicine Research Institute (NuMeRI) adds real-time tracking via nuclear imaging, confirming the nanoparticles hit those elusive TB hideouts.

Ngema refined the system during a three-month TWAS fellowship at RWTH Aachen University in Germany, optimizing release profiles under Prof. Twan Lammers.

“Our early results show that this is possible,” Ngema said. “Now we’re working to translate it to real-world use.”

WADDP Director Prof. Yahya Choonara emphasized the precision angle: “If we want to end TB, we must address the limitations of one-size-fits-all drug delivery. This aligns perfectly with WHO’s vision.”

A Personal Quest for Hope

For Ngema, the fight is profoundly personal. “TB has taken too many lives for too long,” he reflected. “If we can make treatment easier, faster, and smarter, we’re restoring hope.”

In resource-strapped settings, where poverty fuels the epidemic, this innovation could tip the scales: fewer pills, less resistance, and a real shot at eradication.

As Wits pushes the boundaries of nanomedicine, Ngema’s nanosystem isn’t just science – it’s a lifeline, breathing new life into the war on TB.

Follow Wits research breakthroughs at wits.ac.za/news. For more on this project, visit WADDP.