Ending TB in Children Requires USD 120 Million Annually

Chief K Masimba Biriwasha - CNS
According to an ambitious plan launched today by leaders in the TB field, a total of  USD 120 million is require to stem the TB among children (including those co-infected with TB and HIV). The Roadmap for Childhood TB: Toward Zero Death, outlines three priority areas that require attention in order to turn the tide in the fight again TB including: a sense of urgency beyond the TB community, improvement in research, policy development and clinical practices as well as increased funding.

This Childhood TB Roadmap was launched in a press conference in Washington DC by the International Union Against Tuberculosis and Lung Disease (The Union), World Health Organization (WHO) and Stop TB Partnership along with other partners.

For long, TB has wreaked havoc among children. Every day, more than 200 children under the age of 15 die of the disease despite that it is preventable and curable. That is 74,000 child deaths annually, enough to fill a large sized Olympic stadium. But the number could be higher because many children are misdiagnosed, and it begs the question why it has taken so long to address such an important issue.

“The main problem has been diagnosis, from a public health perspective, the focus has been on transmission and the fact that children do not transmit the disease has seen the problem not addressed for a long time,” said Steve Graham, lead writer of the report and current chairperson of the Child TB subgroup of the Stop TB Partnership.

TB in children is often misdiagnosed because the disease hides behind other afflictions like HIV, pneumonia, meningitis and malnutrition which can make the symptoms appear less lethal. As a result, the full scope of the problem is not fully known.

Compounding the problem of diagnosis is the fact that children with TB often come from families that are poor, lack knowledge about the disease and live in communities with limited access to health services. In addition, a combination of lack of health workers, money and – most importantly – medicenes has continued to impede efforts to fight pediatric TB.

The generic drug industry has not been interested in taking up basic pharmacological research,” said Mario Raviglione, Director of the Global Tuberculosis Programme at WHO. While political will to fight childhood TB has increased this has not been met with a concomitant increase in financial resources to address the problem.

“Global estimates indicate that at least USD 80 million per year will be required to address TB in children. An additional USD 40 million per year will be needed for antiretroviral therapy and co-trimoxazole preventive therapy for children con-infected with TB and HIV,” reads the preface to the strategic framework, emphasizing that filling the resource gap would save tens of thousands of children’s lives.

According to Colleen Daniels, Director of TB/HIV at Treatment Actin Group (TAG), new tools will play a key role in addressing TB in children. “Current diagnostics, toxic drugs and inadequate drug formulation are insufficient to respond to the needs of children with TB. New tools will be a crucial part of addressing TB in children and current investments are minimal at best. Much more investment and commitment to childhood TB is urgently needed now.”

The good news is that it doesn’t cost too much to fight the scourge of TB among children. It will cost three cents a day per patient to prevent the disease and fifty cents a day per patient to treat the sick. “Any child who dies from TB is one child too many. TB is preventable and treatable, and this roadmap focuses on immediate action governments can take to stop children dying,” said Mario Raviglione, Director of the Global Tuberculosis Program at WHO.

Chief K Masimba Biriwasha, Citizen News Service - CNS
October 2013 

(The author, born in Zimbabwe, is an Editor, a children's writer, poet, playwright, journalist, social activist and publisher. He has extensively written on health. His first published book, 'The Dream Of Stones', was awarded the Zimbabwe National Award for Outstanding Children's Book for 2004)