CALL TO ACTION for CHILDHOOD TB
We, participants gathered at the ‘International Childhood Tuberculosis Meeting’ held March 17-18, 2011 in Stockholm, Sweden recognize that:
- Worldwide, at least 1 million TB cases occur each year in children under 15 years of age.
- The true global burden of TB in children is unknown because of the lack of child-friendly diagnostic tools and inadequate surveillance and reporting of childhood TB cases.
- Children with TB infection today represent the reservoir of TB disease tomorrow.
- Children are more likely to develop more serious forms of TB such as miliary TB and TB meningitis resulting in high morbidity and mortality.
- Despite policy guidelines, the implementation of contact tracing and delivery of isoniazid preventive therapy (IPT) to young and HIV-infected children is often neglected by public health programmes.
- Most public health programs have limited capacity to meet the demand for care and high-quality services for childhood TB.
- TB care for children is not consistently integrated into HIV care and maternal and child health programs.
- BCG, the only licenced TB vaccine, has limited efficacy against the most common forms of childhood TB and its effect is of limited duration.
- Due to inadequate case detection it is estimated that a large number of children suffering from TB are not appropriately treated. This is further compounded by drug stock outs and the lack of child-friendly formulations of drugs for TB treatment and prevention.
- Children are rarely included in clinical trials to evaluate new TB drugs, diagnostics or preventive strategies.
To address this current situation, we, the undersigned, call for:
- National TB programmes to include and prioritize childhood TB in their national strategic plans in order to address millennium development goals for children and pregnant women.
- All health care providers to integrate childhood TB into their services.
- The scientific community to include children - of all ages - in clinical and operational studies.
- TB drug and diagnostic product developers to specifically include children in development plans and implementation of research at an early stage.
- Donors to encourage collaboration with researchers, local communities, TB and HIV control programmes and other stakeholders to address the growing problem of childhood TB concentrating on:
- Innovative research to develop child-friendly TB diagnostics, drugs, biomarkers and vaccines
- The strengthening of public health facilities and services so that mothers and children with and without HIV can receive appropriate TB care
- Providers of technical assistance to invest in building local technical and programmatic capacity to prevent, diagnose and treat TB in children in all age groups.
- The WHO to accelerate in-country adoption and use of paediatric TB guidelines and coordinate global efforts to collecting and generating data to improve estimates of the childhood disease burden
- Policy makers to adopt the existing and new WHO recommendations for childhood TB, evaluate implementation, scale-up and assess the impact of implementation strategies.
- Civil society to demand equitable prevention, diagnostics, treatment and care services for childhood TB and to monitor the scale- up of these services.
To ensure that all children exposed to TB or suffering from TB are correctly managed and receive the appropriate treatment, the individuals and institutions signing on to this call to action, pledge to advocate for universal access to prevention, diagnosis and treatment of TB for people of all ages. We furthermore call on the international community to endorse this call for action.