Kenya will become the first country to adopt and roll out at the national level the world’s first tuberculosis treatment for children next week.
At least 1 million children are infected with TB every year, and approximately 140,000 children die annually from the disease according to the World Health Organization, though experts fear the number is much higher. The drug’s adoption in Kenya aims to correct a gap in TB treatment that frequently led to incorrect dosages and fueled drug-resistant strains of the disease. The majority of TB-infected children worldwide rely on crushed up, loosely estimated portions of adult dosages, although the roll-out in Kenya is the first of at least three other countries committed at the national level to fixing the problem.
The program comes through a partnership between WHO, Global Alliance for TB Drug Development and UNITAID To develop and bring the drug through clinical trials, and will be implemented by the Kenyan government, local and international partners, including the Global Fund to Fight AIDS, Tuberculosis and Malaria. The collaboration will also serve as a model for the 17 other countries planning to adopt and roll-out the drug in coming years. The partnership has created new opportunities for these and other organizations to work together across sectors on issues facing children.
“Even though the main milestone was to get the product on the market, that gave us the opportunity to really galvanize support for children’s TB, to get a conversation going outside of the medical arena,” Dr. Cherise Scott, director of pediatric programs at TB Alliance told Devex.
Kenya is classified as a high-burden country for TB by the WHO, and Scott confirmed it will be the first to roll out the drug in a national health program since the formulation was approved in November 2015. More than 17 other governments have placed orders for the drug, and several others plan to implement national programs, Mario Raviglione, director of the global TB program at the WHO told Devex in a phone interview.
“Uganda, the Philippines and India will roll out a national program, meaning once those are running, the majority of children with TB will have access to the correct formulation worldwide,” he said.
Kenya, he explained, has been extremely eager to begin roll-out, made easier by its well-established and relatively decentralized network of TB clinics. Other interested countries, however, are not far behind in moving the drug forward.
For Raviglione, it was crucial to reorient the partnerships approach, from working with other health and TB-focused organizations to joining forces with those working on maternal and child health as well as education. These newer collaborations helped correct a small flaw in Kenya’s implementation of TB-related services which previously left children in a lurch.
“National TB programs deliver [medicines] through program clinics,” he said, explaining that TB symptoms can be tough to detect, especially in young children, and often the facilities that offer health services to mothers and children are separate from those with staff trained to detect TB. When mothers brought their children to these pediatrics-focused clinics, the symptoms of TB were often missed.
“In many countries these kinds of services are not well connected to the national programs,” he said. “You would be astonished, there’s so many organizations, private ones too, that work in issues related to children, so simply getting them involved in informing people about child TB goes a very long way,” he said.
Raviglione emphasized that even though well-heeled organizations such as the Global Fund provide generous funding for TB programs, “only 15-20 percent of this money goes to TB, despite being the number one killer among infectious diseases,” he said. This is one reason it’s taken so long to develop child-safe formulations and dosages, he added, and yet another reason why those working on TB must cross sectors to achieve the greatest impact.
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