MSF Calls for Urgent Action on Pediatric TB

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Too many children with TB are neither tested nor treated, with many countries including the Philippines failing at the first hurdle: updating policy guidelines in line with WHO recommendations

Doctors Without Borders (MSF) has called on governments, including the Philippines, to urgently reform and implement policies for diagnosing and treating tuberculosis (TB) in children, citing alarming gaps in care that leave millions of young lives at risk.

In its newly released report, TACTIC: Test, Avoid, Cure TB in Children, MSF revealed that many high-burden TB countries, including the Philippines, lag behind in aligning national guidelines with updated World Health Organization (WHO) recommendations for pediatric TB care.

“TB is curable, also in children,” said Stijn Deborggraeve, Diagnostics Advisor at MSF Access Campaign.

“Yet countries are lagging behind in adopting and implementing these solutions for testing, preventing, and treating TB in children. We can no longer afford inaction—every delay means that more children die unnecessarily,” he added.

The report evaluated TB policies in 14 high-burden countries, including the Philippines, showing significant gaps in diagnosing TB in children. For instance, only five countries allow treatment to start based on symptoms when lab results are unavailable.

Inadequate resources further hinder implementation, with only four of the 14 countries possessing the capacity to operationalize this policy effectively.

According to WHO estimates, 1.25 million children and young adolescents contract TB annually, but only half receive treatment. In 2023, TB re-emerged as the world’s leading infectious disease killer, claiming 1.25 million lives globally.

The Philippines, one of the top eight countries with the highest TB burden, faces a steep challenge. Despite updated WHO recommendations for shorter, child-friendly treatments introduced in 2022, their rollout remains slow.

Filipino TB doctor Trisha Thadhani from MSF’s TB project in Tondo, Manila, shared firsthand success stories with updated treatments.

“Since the older children have been able to benefit from the shorter three-month, once-weekly TB preventive treatment, they have really appreciated how easy it is to take, as have their parents. The adherence to treatment is much improved,” said Dr. Thadhani.

MSF emphasized that countries must also ensure access to new pediatric TB formulations, which simplify dosing and reduce side effects.

“It’s unfortunate that child-friendly formulations of TB drugs are still not available in many countries due to bureaucratic barriers and funding gaps,” said Dr. Cathy Hewison, Head of MSF’s TB Working Group.

“Children with TB are forced to swallow crushed and bitter medicines without appropriate weight-based doses, putting them at grave risk of side effects and treatment failure. This neglect must end now,” Dr. Hewison added.

MSF has called on governments to urgently align national guidelines with WHO standards, allocate resources for policy implementation, and remove bureaucratic barriers to procuring child-friendly TB treatments.

The group also urged international donors and health organizations to provide funding and support to ensure children with TB receive timely, quality care.

The media orientation held by MSF on November 29, 2024, highlighted the grim reality of the TB epidemic, with 10.8 million new cases and a 4.6 percent rise in TB incidence globally from 2020 to 2023.

Two-thirds of the world’s TB cases are concentrated in eight countries, including the Philippines, which underscores the urgent need for national and international action.

“The tools and treatments we have must reach the children who need them most—now,” said Dr. Hewison.

MSF’s report serves as a stark reminder that ending the pediatric TB crisis will require not just updated policies but an unwavering commitment to implementation and funding.