The End TB Strategy: Opportunity to End TB in Children

Professor Stephen Graham is a Paediatrician with more than 20 years’ experience in international child health in developing countries such as in African and Asia-Pacific regions. His working interests including childhood respiratory diseases such as TB and pneumonia in developing countries. He is the leader of International Child Health Group at the Murdoch Childrens Research Institute, the University of Melbourne, Australia and current chair of the Child Tuberculosis (TB) subgroup of World Health Organization (WHO) Stop TB Partnership. He is also member of the Strategic Technical Advisory Group on TB for the WHO, Wellcome Trust, UK, and National Institutes of Health, USA. He has been the recipient of multiple prestigious research grants such as NHMRC and USAID and has published hundreds of peer-reviewed journals.

During his expert talk, Prof Graham delivered that TB remains a significant public health problem worldwide. However, in the last decade between 2000-2013, through effective prevention, diagnosis and treatment of tuberculosis, 37 million lives were saved. Despite a great TB burden reduction, formidable challenges are remaining such as reaching the missed cases, addressing MDR-TB, responding to TB/HIV, increasing financing to close resources gaps and intensifying research and ensuring rapid uptake of innovation. In the Sustainable Development Goals 3 (SDGs), the paradigm has now change from “halting TB” to “ending TB” and ultimately eliminating it by 2030, which is an ambitious goal.

Child TB is common wherever adult TB is common and children are the victims of poor adult TB control program. It is estimated that about 6% of new cases of TB occur in children and TB is one of the major causes of death in children. In the past, childhood TB was neglected in the National TB program (NTP), in which the main priority has been given to infectious adult cases. However, in the last few years childhood TB has received increased attention from global health experts and NTPs. There has been improvement in the diagnosis, such as the use of Xpert that is more sensitive and specific than smear and faster than culture, and in treatment, such as new child-friendly correctly dosed fixed-dosed combinations of the generic drugs used to treat TB that is palatable. All of these strategies will require strengthening of collaboration between the child health sector and National TB Programs.

By dr Rina Triasih M.Med (Paed), PhD, Sp.AK/ dr Vicka Oktaria, MPH