No child should die of TB. TB Alliance and partners have developed medicines to improve treatment and child survival from TB.
Here's where we stand today:
Simple Treatments, Designed for Children
Improved medicines for children with drug-sensitive TB means tablets in the correct fixed dose combinations of the three most commonly used anti-TB drugs, rifampicin + isoniazid + pyrazinamide, used for the initial two months of treatment, followed by four months of rifampicin + Isoniazid. These products offer significant advantages over previous drugs including:
- Fixed dose combinations in the correct, WHO-recommended dose – no need for crushing or chopping
- Quickly dispersible in liquid - Easy to for parents to give and for children of all ages to take
- Palatable fruit flavors
- Expected to improve treatment adherence and outcomes
The Right Medicines
The right medicines in the right doses will improve adherence and save more lives. This is an important step in improving treatment and child survival from TB, and slowing the spread of drug-resistant TB.
Simple TB medicines for children eases the TB burden on healthcare systems. Simpler TB medicines for children can allow healthcare systems to scale up treatment. Fewer pills will simplify ordering and storage.
Child-friendly medicines improve the daily lives of children and their families struggling with TB. Six months is a long time to take medicine. But the availability of treatment that tastes good and is simple to provide will ease the daily struggles of children, parents, and caregivers alike.
TB Alliance has collaborated with a network of technical partners to ensure that the new formulations reach every child in need. In additional to country partnerships, this includes the World Health Organization, MSH/SIAPS, UNICEF, the Stop TB Partnership's Global Drug Facility, Childhood and Adolescent TB Working Group, The Global Fund to Fight AIDS, Tuberculosis, and Malaria, Desmond Tutu TB Centre, the United States Agency for International Development (USAID), KNCV, The Union and Baylor College of Medicine, among others.
This initiative received support from Unitaid, the major funder, as well as USAID, the UK Department for International Development (DFID), Irish Aid, the Australian Department of Foreign Affairs and Trade (DFAT) and the Dutch Ministry of Foreign Affairs (DGIS).
Visit our Pediatric TB Resource Center for more information about the childhood TB burden and improved cures for children. Correctly-dosed medicines are now available. Children, their families, communities, and countries must use their voices to advocate for improved diagnosis and care of children with TB.
MDR-TB + Kids
For many children, MDR-TB and its treatment is so difficult that it requires hospitalization. Treatment for MDR-TB is typically 18 months, but could last as long as 30 months. Almost none of the existing “second-line” TB drugs used to treat MDR-TB are available in child-friendly formulations. Drugs for MDR-TB need to be put together into complicated regimens, which can include as many as 20 pills a day, plus injections. Pills are often hard to swallow, taste bad, and have many side effects. Injectable drugs are known to cause deafness in a large number of children. In HIV-infected children, the pill burden is even higher since they need to take antiretroviral therapy. MDR-TB treatment designed for children that is safe, humane, and affordable is a global health and moral imperative.
TB and Babies
Pregnant women in settings with high TB burden are very susceptible to developing TB, especially if they have HIV. In turn, their newborn babies can be infected and contract the disease when they are most vulnerable, in the first weeks of life. That was the case with Ayanda, who was diagnosed with TB shortly after birth and spent five months in hospital on daily treatment. But just how much drug the baby should receive was a guessing game, as the appropriate doses of TB drugs have not been established in very small infants. “We often have to split existing formulations and getting the right dose for small children is challenging,” says Dr. Anneke Hesseling, from the Desmond Tutu TB Centre. “For babies, not only can it be difficult to administer the drugs, but we don’t actually know if the recommended dose of TB drugs is safe in very small babies. We urgently need more information on dosing and drug formulations that can also be used in infants.”
Latent TB in Children
Recent data show that 53 million children harbor a latent TB infection. Although these infected children may not currently be experiencing any symptoms, they represent the pool of TB infection for many years to come. Young children and those with HIV are especially at risk. Today, the focus of TB control efforts is on the detection and management of active TB in children. However, to reach the Global Goals, a new focus is emerging on preventing TB through treatment of latent disease. The treatment of latent TB may be the most effective way to reduce incidence of TB, but current therapy requires millions of children, who are otherwise healthy, to take 3-9 months of anti-TB therapy. To increase acceptability and achieve significant progress in widespread treatment of latent TB, development of shorter drug regimens with lower toxicity and side effects are require.