In the global fight to end tuberculosis (TB), the Desmond Tutu TB Centre (DTTC) at Stellenbosch University in South Africa stands at the forefront of efforts to address an all too often neglected group affected by TB—children. Since its founding in 2003, DTTChas established itself as a global leader in pediatric TB research, advocacy, and policy influence, while also contributing to broader health outcomes including health system strengthening and HIV prevention. With a clear-eyed focus on the needs of children affected by TB and a deep commitment to collaborative, evidence-based interventions, the DTTC has played a transformative role in shaping the response to pediatric TB—both in South Africa and worldwide.
Bringing Pediatric TB Out of the Shadows
For millennia, TB has been one of the world’s deadliest infectious diseases, yet children have traditionally been overlooked in the global TB response. Pediatric cases were often underdiagnosed, undertreated, or excluded from research trials and improved treatment formulations. DTTC recognized early on that without targeted approaches for children, global TB control efforts would fail to reach these young populations.
Led by internationally respected TB researchers and clinicians, DTTC has been instrumental in driving research and advocacy to improve diagnosis, treatment, and prevention of TB in children. Its work includes ground-breaking research, leading and participating in studies on TB transmission dynamics, pediatric TB burden, and effectiveness of new treatment approaches.
Advancing Pediatric TB Treatment Through Collaboration
A hallmark of DTTC’s success has been its willingness to collaborate, and one of its most impactful partnerships has been with TB Alliance. DTTC was a critical implementation and research partner, as well as strategic advisor in the STEP-TB project (Speeding Treatments to End Pediatric TB), which was funded by Unitaid. This global initiative reshaped the market for pediatric TB drugs by reducing barriers to entry, engaging in innovative industry collaboration to launch optimized medicines, and mobilizing strong demand.
STEP-TB addressed the lack of child-friendly TB medicines available first by reviving market interest in pediatric TB drugs by more accurately estimating the burden of childhood TB. Then, the initiative supported the development and introduction of pediatric formulations of drugs for drug-sensitive TB (DS-TB). These fixed-dose combinations followed WHO dose recommendations, which meant there was no longer a need to chop or crush adult pills to guess a child’s dose. The medicines were quickly dispersible in liquid and were made in fruit flavors, making it easier for caregivers to give and for children of all ages to take.
DTTC played a critical role in developing evidence to support new formulations and dosing for these medicines and then in helping to support guideline changes to facilitate their global uptake. To date, more than one million courses of these flavored, dissolvable, child-friendly treatments have been procured by nearly 130 countries, a major improvement over the crushed adult pills that had long been the norm.
BENEFIT Kids: A Broader Vision for Childhood TB Care
Building on the progress of STEP-TB, DTTC has also partnered with TB Alliance, and many other key collaborators, on the BENEFIT Kids project (Better Evidence and Formulations for Improved Pediatric TB Treatment), a comprehensive initiative to close persistent gaps in pediatric TB care. BENEFIT Kids aims to strengthen the entire continuum of TB care for children—encompassing prevention, diagnosis, and treatment for both drug-sensitive and drug-resistant TB (DR-TB).
BENEFIT Kids is involved in seven clinical trials across South Africa, the Philippines, and India, focused on improving treatment and prevention strategies. It is also conducting two systematic reviews to evaluate the existing evidence on DR-TB treatment. These efforts are designed to build a stronger evidence base around optimal dosing, safety, efficacy, acceptability, and cost of pediatric TB medications. In addition, the project is generating essential data on more child-friendly formulations—including better-tasting therapies for both treatment and prevention—and will launch the world’s first clinical trial focused specifically on preventing DR-TB in children.
DTTC plays a pivotal role in BENEFIT Kids, contributing expertise to field research, operational support, and stakeholder engagement. Its researchers have helped evaluate novel diagnostic tools for children, pilot improved treatment strategies, and gather evidence to inform national TB programs. DTTC also supports the development of simplified dosing guidance and educational materials for healthcare providers.
By advancing evidence-based, child-centered solutions and working to integrate them into health systems, DTTC continues to exemplify how academic and research institutions can drive real-world impact.
A Catalyst for Change in South Africa and Beyond
Located in Cape Town, South Africa, DTTC is at the heart of one of the global hot spots for TB and the world’s epicenter of TB research. This nexus uniquely positions DTTC to combine cutting-edge science with close connections to community engagement. Its team works closely with regional and national TB programs, contributing expertise to policy development and capacity building. DTTC also trains new generations of researchers and healthcare providers, many of whom are now leading TB initiatives across Africa and beyond.
In addition to its work on pediatric TB, DTTC contributes to TB prevention strategies, maternal and child health, and the social determinants of TB. Its cross-disciplinary approach reflects the recognition that ending TB requires more than new tools; it demands a comprehensive response that addresses access and community empowerment.
A Valued Member of TB Alliances Stakeholders Association
As the global TB community strives to meet ambitious targets, the role of organizations like the Desmond Tutu TB Centre is more vital than ever. DTTC brings to the Stakeholders Association a deep pediatric expertise, network and relationships with key partners, and a spirit of open collaboration, which will help inform TB Alliance’s efforts to ensure young people are able to benefit from new TB treatments as soon as possible, while continuing to prioritize safety.