This article was written by Dr. Lucica Ditiu, Stop TB Partnership, Mr. Lelio Marmora, UNITAID, Dr. Mario Raviglione, WHO, Dr. Mel Spigelman, TB Alliance, and Professor Stefan Swartling Peterson, UNICEF
The news last year about the first-ever availability of medicines designed for children with tuberculosis (TB) was welcomed by a field that has been far too neglected.
Worldwide, nearly 10 million people get sick with TB every year and 1.5 million of them die as a result. Although TB is the deadliest infectious disease alongside HIV/AIDS, it is shocking how little attention it has garnered, not only within the general public, but even within the medical community.
For children, TB has been a most notable silent killer, claiming the life of one child every four minutes. One million children get sick each year; two thirds of them are never diagnosed (at least not in the public sector) and therefore are unable to get the quality treatment they need.
And this is just the tip of the iceberg: At least 53 million healthy children are now infected with the bacteria that causes TB. If they do not access preventive treatment, they can become sick. These children are the reservoir of TB for decades to come.
No child should die of TB, not when this is a disease that can be prevented, diagnosed and cured.
On World TB Day, it is time to call for a change. The global health community has come together to introduce the Louder than TB campaign to end preventable deaths from TB.
Through this campaign, we are asking governments, decision-makers, donors, and others for the following:
Better awareness of TB at all levels of the health system: Even in places where children have access to health care, TB symptoms are often mistaken for other common childhood illnesses, and doctors often do not suspect or even inquire about TB. Training primary health care workers and medical practitioners in how to identify, prevent, and treat TB is critical.
Integrated care: Children affected by TB should be able to find care at the community or primary care health level that offers regular services for women and children. National TB programmes need to work closely together with other programmes delivering maternal and child health, HIV care, and nutrition services.
More innovation to develop improved diagnostic, treatment and preventive tools: With investment from UNITAID and others, there are now TB medicines available for children in the right doses and fixed-dose combinations, making treatment easier than ever. Countries must adopt these medicines and make them available at once. At the same time, there is still no simple way to diagnose, treat, and prevent TB. Innovative new tools are needed to provide rapid and accurate diagnosis –particularly at the primary health care level. Treatments need to be shorter and well tolerated. A vaccine that provides full and lasting protection would be a potent tool toward ending TB in children.
More resources: Eliminating TB will require $65 billion over the next five years, double the current funding levels. Neglecting proper care will result in more suffering and deaths as well as development of drug-resistant TB, which is more deadly, more expensive to treat, and already a major public health threat in many settings. Medicines for drug-resistant TB are literally thousands of times more expensive than those for drug-sensitive TB, and treatment requires 2 years or more to complete.
In September last year, world leaders rallied behind the Sustainable Development Goals and pledged to prevent pandemics, end preventable deaths, and build resilient health systems. Without tackling TB, these Global Goals will not be met.
This World TB Day, let’s start a new movement of universal care, for children, against TB.