Acting on the Call: Bring childhood TB out of the shadows
No child should die of tuberculosis (TB). Yet each year, at least 1 million children get sick with TB and nearly 400 of them needlessly die, each and every day. TB in children can be prevented, diagnosed and cured, but all too often, children with TB remain in the shadows, uncounted and untreated.
There was broad support for a Call to Action, launched in March 2011 at the International Childhood Tuberculosis Meeting in Stockholm, Sweden, which called for enhanced efforts to meet the needs of children with TB globally. Since then, substantial progress has been achieved, including a strengthening of global political commitment to tackling childhood TB; the development of the Roadmap for Childhood Tuberculosis; creation of guidelines and training materials for national TB programs on the management of TB in children; expansion of programmatic activities at regional and country levels; improved understanding of the TB burden; expansion of research leading to important progress in clinical trials; and now, the introduction of appropriate, child-friendly medicines for drug-sensitive TB.
Despite this progress, significant challenges remain to meet the objective of the Post-2015 WHO End TB Strategy and United Nations Sustainable Development Goals -an end to the tuberculosis epidemic. There is an unprecedented opportunity to address the needs of children and adolescents with TB, and must be embraced.
We, the undersigned, recognize that:
- TB continues to be overlooked as an important cause of morbidity and mortality in children and adolescents and this contributes to a lack of commitment and resources for childhood TB.
- Implementation of interventions for effective prevention and management of TB in children requires the engagement of the entire health sector, including existing reproductive, maternal, newborn, and child health programs. Coordination and cooperation will need to be strengthened to address the existing gaps between policy and practice.
- The availability of child-friendly TB treatments in the WHO-recommended dosages should catalyze the necessary shifts in policy, practice, and resource mobilization to give children the best chance of survival. This must include strengthening of health systems, ensuring that countries are equipped with the tools needed to prevent and diagnose TB and manage the disease with the best treatments available.
- Improved diagnostics, vaccines, and medications for children are needed to eliminate TB. Efforts will be needed to address the woefully inadequate investment for their development.
Almost five years after the first Call to Action, it’s now time to unite and focus on the following priority actions:
- Empowering children, their families, and communities to use their voices to advocate for improved access to TB prevention, diagnosis and care.
- Stepping up programmatic efforts to identify children and adolescents most at risk of TB and prevent, diagnose and treat them with the best diagnostic tools and medicines available.
- Strengthening health systems at all levels, recognizing the fact that tuberculosis contributes substantially to the global burden of child morbidity and mortality. Integrating, where possible, TB programming with programming focusing on maternal and child health, HIV/AIDS, and nutrition.
- Including, at an as early a stage as possible, children and adolescents in research activities, thereby accelerating the development of appropriate diagnostics and treatments.
- Facilitating, by governments, of registration and adoption of improved treatments and interventions for children.
- Ensuring affordable supply of treatments and diagnostics from manufacturers.
- Scaling up donor investments in the long-term development of appropriate childhood tuberculosis medicines, diagnostics, and vaccines, and the health systems that use them.
The signatories pledge their support, and furthermore call on the international community to endorse this call for action.