By Sharon Atieno

A pediatric drug-resistant TB (DR-TB) initiative was officially launched by the Stop TB’s Global Drug Facility (GDF).

“As a pediatrician, I probably see the worst end of the spectrum of tuberculosis: it can cause such damage to little bodies. Drug resistant-TB treatments that use injections and adult tablets for babies are horrible, the equivalent of chemotherapy. We should not have to inflict such terrible pain to our smallest patients to save them,” said Dr. Vanessa Rouzier, Chief of Pediatrics, Gheskio – Haitian Global Health Alliance at the event in Jakarta, Indonesia.

Despite children requiring different formulations for treatment than adults- smaller in size and that can be taken easily such as, dispersed in water rather than crushed and mixed, the treatment for children with DR-TB initially involved medicines intended for use by adults.

With very few children with DR-TB being diagnosed and treated globally, getting these new formulations developed, produced and distributed is difficult.

The Pediatric Drug-Resistant TB Initiative aims to ensure access to the best possible treatments for children. GDF together with the Sentinel Project on Pediatric DR-TB worked to identify early adopter countries that could implement the new pediatric formulations quickly and pooled their demand, leading to the introduction of these life-saving medicines in countries in less than 12 months.

A panel discussion at Stop TB event

Already procured by 56 countries and introduced in Haiti and Nigeria, among others, the oral medicines come in a dissolvable, flavored form—replacing the adult doses in tablet form that had to be crushed or split so that the proper therapeutic levels could be met and removing the injectables with their terrible and permanent side effects. GDF was also able to negotiate substantial price reductions, ranging from 30% to 85%, depending on the medicines used.

Noting that the statistics on effects of TB on children is small thus, often ignored, Dr. Osagie Emmanuel Ehanire, Health Minister, Nigeria and Stop TB Partnership Board Member said: “Nigeria was one of the first countries to introduce new child-friendly, all-oral medicines for the treatment of pediatric drug-resistant TB (DR-TB), thanks to grants provided by Stop TB’s Global Drug Facility with funding from the government of Japan and USAID. No child should have to suffer from DR-TB and we are committed to reaching these young children and treating them with these new medicines.” 

“We need to do better. When you save a child, you can add 80 years to her or his life—and these new child friendly TB medications make that possible. No more injections, no more terrible side effects,” adds Dr. Rouzier.

Of the estimated 1.1 million children under the age of 15 who became sick with TB around the world in 2018, an estimated 32,000 had DR-TB. Of those, fewer than 5% are diagnosed and receive treatment.

In 2019 alone, Stop TB’s GDF provided over 1,100 treatments for children with drug-resistant TB around the world, more than double the number of children under five years of age historically treated each year for DR-TB.
However, the world is far away from the 2018 United Nations High-Level Meeting on TB and Global Plan to end TB target of treating 115,000 children with DR-TB by the year 2022, including 47,000 young children in need of these new, child-friendly formulations.