A Message from CORE Group’s Pediatric TB Interest Group

When I first got involved in the global TB world about eight years ago, one of my first questions was “Why don’t TB programs treat children with TB?” I was told basically, from a public health perspective, it was because children aren’t infectious. Well, as a mother of three, that rationale would not work for me if one of my children had TB. In fact, of course children with TB are treated in the U.S. It’s a different story for children in low-income countries that are always at the back of the line for everything, TB care being no exception.

Since that time, the world of global TB has been evolving rapidly—becoming a more diverse, innovative field, and much more dynamic. Thanks to a few visionaries, we now believe it is both possible and worthwhile to protect children from this preventable, curable disease, and to successfully care for those children who have TB. This simple vision was not even seriously considered a mere eight years ago. How ironic considering this is a disease as old as humanity.

The bad news is that most children with TB in low-resource settings STILL DO NOT have access to protection, diagnosis, and treatment of TB. They suffer and die. The urgency is especially notable in high HIV settings.

What can we do to make up for lost time? We need to get proper systems into place to collect data on the prevalence of childhood TB and then use that data to hold everyone—including ourselves—accountable for doing something about it.

While that happens, we can begin now to work together to build pediatric TB prevention and care into all levels of global health, from global alliances to national health systems to community-level programs. This should include policies, protocols and resources for screening and referrals, contact tracing, services including diagnosis, treatment and preventative therapy, and community mobilization. Integrated program efforts are called for that link TB efforts with maternal health, child health (including nutrition), HIV, and all health programs. This will entail building strategic, logical and practical connections between people and programs that currently have few or no linkages whatsoever. And it all needs to be done from the perspective of the child and his or her family. How best to reach them, and provide care and treatment?

My grandmother, a physician, spent several years of her life in a TB sanitarium in the 1940s. When I was growing up, that seemed like ancient history to me. But, right now, as you read this, a child is coughing. TB is a real and present danger, trying, probably successfully, to steal her future. That child—and millions of others—need our help. Why aren’t they getting it?

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CORE Group’s 60+ member and associate organizations reach 720 million people a year in 180 countries. (That’s a tenth of the world’s population) Historically, non-governmental organizations (and even Ministries of Health in some cases) were barred from getting involved with TB. Thus, our group has relatively little collective expertise in TB programming.

But we do have a LONG history of successfully working with communities and governments on pressing health and development problems in low-resource settings. CORE Group’s multi-organizational TB Working Group seeks to accelerate the ease and pace with which our members can effectively integrated TB—including pediatric TB—care and control into their work. We have found, time and again, that if we all work together on these issues, progress comes quicker, and on a larger scale.