Tuberculosis medicines for children
At least 1 million children get TB each year, and another 140,000 die from the disease. Yet until recently, there has been no appropriate medicine for children with TB, despite revised WHO guidelines. Faced with a lack of appropriate medicines for children, care givers crush and split tablets, which creates a risk that the right amount of medicine is not provided. Insufficient amounts of medicine lead to incomplete treatments and higher rates of drug-resistant TB.
Making the switch to the new medications
After a push by international partners to improve market information and incentives, production of quality-assured, child-appropriate TB medicines has begun. The next challenge for countries is to transition from the old form of treatment for children, to the new child friendly formulation.
“This requires significant preparation and planning,” says Xiulei Zhang, from the Essential Medicines and Health Products Department of WHO. “Old formulations need to be phased out, and new formulations need to be phased in. This requires work to address the key steps for introducing the new fixed-dose combinations for children, such as registration through national regulatory authority, updating treatment guidelines and inclusion in National Formulary and/or National Essential Medicine List, and generation of adequate transition timelines.”
Planning must be done in advance to avoid gaps between supplies of the old medication being exhausted and the new medication arriving. “It is important that forecasting and quantification of the needs of new paediatric fixed-dose combinations is properly undertaken,” says Dr Zhang. Equally important is that each country has special conditions, such as policies on destroying any unused medicines from old formulations.
WHO is helping countries make a smooth transition, by assisting National TB Programmes to carry out the key steps to increase the uptake of improved treatment for children and to strengthen health systems at all levels.