Prior to World Tuberculosis Day, Medesin calls on Frontieres (MSF) to all countries and international donors, calling for prioritization and ensuring sustained investments to diagnose, treat and prevent tuberculosis (TB), especially in the most vulnerable children.
Every three minutes, the child dies of tuberculosis. The World Health Organization (WHO) estimates that 1.25 million children and young adolescents (ages 0-14) get sick every year at TB, but only half of these children are diagnosed and treated. In 2022, we revised guidance on managing children and adolescent managers using TB. MSF Project Tactics – Testing, Avoidance, TB treatment, TB treatment for children, and implementing new WHO recommendations in programs in over 12 countries in Africa and Asia, already documenting an increase in children diagnosed with tuberculosis and receiving appropriate treatment.
However, we are deeply concerned about recent US funding cuts. The United States is the largest financial contributor to the tuberculosis program, accounting for half of international and bilateral donor funds, according to the WHO.
We worry that cutting funding in the US will have a disproportionate impact on children…we cannot afford to sacrifice funding decisions to the lives of our children. Dr. Ei Hnin Hnin Phyu, Medical Coordinator at MSF Pakistan
“For years, we have witnessed the fatal gaps children face in accessing the diagnosis and treatment of tuberculosis in the country we work for,” says Dr. Kathy Hewison, head of MSF’s TB Working Group. “Children at risk of suffering from tuberculosis are often overlooked either because they have not been diagnosed or are facing a delay in diagnosis.”
“Now, with recent cuts in US funding, these gaps in identifying and treating children at TB will widen further, threatening to roll back years of advances in tuberculosis care,” says Dr. Hewison. “We urgently call on all countries and international donors to step out and ensure sustainable funding for tuberculosis care, especially for young children.
The MSF team in Sindh, Pakistan, has witnessed US funding cuts that have led to disruptions in community-based services. These services play an important role in countries with a high burden of tuberculosis, particularly in aggressive screening of people in communities that increase diagnosis – screening high-risk families, and providing preventive care for children.
We urgently call on all countries and international donors to secure sustainable funds for TB care in all countries. Dr. Kathy Hiwison, Head of MSF TB Working Group
“Children are already very vulnerable to tuberculosis and are worried that US funding cuts that have affected community-based services will have a disproportionate impact on children. “We cannot afford to sacrifice our children’s lives.”
For example, children with weakened immune systems due to HIV infection or malnutrition are the most vulnerable and are disproportionately affected by tuberculosis, HIV and the destruction of nutrition services.
Children with tuberculosis are often excluded from research and development trials being conducted with new tools for tuberculosis. Recent cuts in US funding have halted numerous clinical trials and retreated TB research and innovation, many of which are important for children with TB. This is a major step in the fight against tuberculosis as it slows the development of much-needed diagnosis and treatments for children. In search of the pharmaceutical industry and international donors, MSF ensures sustained investment in the development and evaluation of medical tools that can improve TB care in children.
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MSF is the largest non-government provider of tuberculosis treatment worldwide, and has been involved in tuberculosis care for 30 years, often working with the National Health Authority to treat people in a variety of environments, including conflict zones, urban slums, prisons, refugee camps and rural areas. MSF is also involved in efforts to find shorter, safer drug-resistant TB treatment regimens through three clinical trials: TB-Practecal, EndTB and EndTB-Q. WHO recommendations for four 6- and 9-month regimens for treating DR-TB (including BPALM and BPAL) were primarily driven by evidence from the TB-PracteCal and ENDTB trials.
MSF is implementing integrated project tactics – testing, avoidance and treating TB – aimed at implementing new WHO recommendations to improve the management of TBs in children in MSF programs in over 12 countries in Africa and Asia. Furthermore, the project strives to demonstrate the effectiveness and feasibility of recommendations in the context of various nationalities through operational research, and advocates for the widespread implementation of the entire national health system.
