Change the Game: An agenda for action on childhood tuberculosis

March 19, 2018

As part of the Sustainable Development Goal agenda, the world has committed to ending preventable child deaths by 2030. Yet every day, nearly 700 children die from tuberculosis (TB), 80% of those before reaching their fifth birthday. Treatment exists that could prevent nearly all of these deaths, but less than 5% of the children who need it receive access.

This brochure presents key facts and figures about childhood TB  as well as an agenda to end the disease in children worldwide.

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Key findings from the brochure:


Child deaths from TB ultimately result from four key gaps.

  • The prevention gap: the failure to prevent TB disease through preventive therapy for at-risk children.
  • The detection gap: the failure to diagnose TB disease in children.
  • The treatment gap: the failure to ensure timely access to effective treatment.
  • The research and investment gap: the failure to prioritize research and investment focused on the needs of children.


The Prevention Gap


Each year, around 7.6 million children aged 0–14 are infected with the TB bacterium. 2.4 million children under the age of live in houses with a known adult or adolescent with TB. Low-cost, high-impact treatment is available to prevent TB disease in these high risk children, but in many cases, these are not being utilized effectively. As a consequence, more children fall sick and die from TB disease and countries are faced with the substantial economic burden of TB treatment and mitigation.



The Detection Gap


One million children aged 0-14 are estimated to fall ill with TB every year, this is one in 10 TB cases. For children under 5 years of age, only 26 per cent of the estimated 540,000 annual TB cases are accurately diagnosed and reported. This stands in stark contrast to the 60 per cent of cases which are accurately diagnosed among older children and adults aged 5 and above.



The Treatment Gap


When they receive appropriate treatment with affordable, child-friendly medicines that are widely available, less than 1 per cent of children with TB die. However, as a consequence of the case detection gap, over 96 per cent of TB deaths among children under the age of 15 are among children who never accessed treatment.



The Research and Investment Gap


Low levels of investment limit research and innovation to help children with TB. A lack of public awareness and funding, and regulatory conditions that hinder effective research, is slowing the development of child-friendly diagnostic tools, more effective vaccines and shorter, safer regimens for the prevention and treatment of all forms of TB.


An Agenda for Action


Political commitment, targeted investment and coordinated multi-sectoral planning and service delivery can change the game for children with TB, saving millions of lives. Ending child deaths from TB must remain a top priority at global, national and community levels.



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