Doctor checking child for TB

Credit: Gary Hampton

A new report, Children and Tuberculosis: From Neglect to Action, outlining recommendations on how the international community and affected countries can combat childhood TB was released today by the ACTION global health advocacy partnership. 

Despite the international community paying increasing attention to the issue of childhood tuberculosis and despite it being both preventable and treatable, TB remains a top ten killer of children worldwide. The WHO estimates 490,000 children get sick with TB each year, and up to 64,000 die as a result – although experts agree that actual figures are much higher.

The report highlights the various issues facing children, predominantly the most vulnerable living in poverty, with TB. Not only are children prime targets given that their immune systems are not fully developed but the risk is further exacerbated by the lack of any appropriate, quality-assured paediatric TB drug formulations. As the report states:

Drug companies perceive paediatric TB to be a small market with little profit. As a result, children are routinely excluded from drug treatment clinical trials and few child-friendly TB drugs exists, such as liquids or chewable tablets.

In addition to the lack of child-friendly diagnostics, drugs, and vaccines, children are often overlooked or misdiagnosed in National TB Programmes.  This is for a range of reasons including the fact that TB is often considered an ‘adult’ disease, that children are on average less contagious, and as a result of the prevalence of other childhood diseases such as pneumonia, which mimics many of the symptoms of TB.

It is not only the health effects that are outlined as a considerable concern. The report highlights the case of the parents, Meenu and Gyanchnad*, whose two children caught TB. As a result of the TB diagnosis, Meenu and Gyanchnad  were forced to mortgage their home just to pay for their children’s stay in hospital. As well as facing economic hardship and having to deal with the health impact of TB itself, the family were also suffered from intense stigma in their community, causing the children, Akash and Praveen*, to be expelled from school. While Akash and Praveen are today on the road to recovery, their story highlights the myriad of problems associated with childhood TB.

What is clear from the report is that there is an urgent need for action. The ACTION global health advocacy partnership makes some core recommendations for donor governments and high burden countries to tackle the rates of children with TB and the knock-on financial and social difficulties faced by millions.

Donor governments should:

  • Address TB as part of child survival initiatives and increase funding for programmes that address childhood TB – particularly the Global Fund to Fight AIDS, Tuberculosis, and Malaria.
  • Provide additional resources to be invested in developing child-friendly diagnostics, drugs, and vaccines.

High burden countries:

  • National TB Programmes must collect and report on childhood TB data.
  • Governments must increase funding for TB programmes, including training and supporting health workers, and also address TB as part of a wider poverty and child survival agenda.

You can read the full report by clicking here.

*All names have been changed to maintain confidentiality.