shedding light on the silent crisis: tuberculosis in children 

By: Results Canada Published: 24/03/2024

In 2020, 11-year-old Francis Aisaga and his family had to travel from their village Inawabui, Papua New Guinea, to the capital city 150 kilometres away to finally be diagnosed with multi-drug resistant tuberculosis (TB) – a form of the disease that does not respond to many of the regular treatments.

This was terrible news for Francis and his family. But they did not give up.

With his family and dedicated healthcare workers by his side, Francis embarked on a grueling 18-month treatment journey requiring monthly trips to the capital Port Moresby to get unpalatable medications with serious side effects.

But many do not have the options Francis had that saved his life.

Every year, TB affects a shocking 1.3 million children and over half remain undiagnosed and untreated. Tragically, 18% succumb to the disease. In fact, TB is the deadliest infectious disease worldwide and symbolizes profound global health disparities, disproportionately affecting marginalized communities. Children, among the most vulnerable, suffer silently on the fringes of global health priorities.

Diagnosing TB in children in the first place presents formidable hurdles. Due to their unique physiology, over half of pediatric cases go undetected or unreported and mortality rates are high. The difficulty lies in obtaining sputum samples, the primary diagnostic method, along with low bacterial levels in children’s lungs. Even with a diagnosis, the problems persist as TB treatments are often unsuitable for children. Sadly, childhood TB is rarely centred in global health responses, impeding efforts to combat this disease.

However, timely diagnosis and treatment are possible. Investments from countries like Canada to the Global Fund to Fight AIDS, Tuberculosis, and Malaria offer children like Francis a chance. In 2022, Canada's historic $1.2 billion pledge to this international mechanism and its investment to the Stop TB Partnership’s TB REACH initiative provided lifesaving solutions to countless children. Francis's story is a testament to the progress achieved through global collaboration and investment.

Canada's role in combatting TB cannot be understated. Yet, its contributions to TB research and development have fallen short of global commitments. The existing arsenal of TB tools remains antiquated and unsuitable for pediatric patients, exacerbating the challenges in prevention, identification, and cure.

Despite being a very urgent and current epidemic, TB continues to be fought with (for the most part) 19th century tools. The only TB vaccine is over 100 years old, and its efficacy remains limited, particularly beyond early childhood.

Recent research into new vaccines, diagnostics, and treatments – particularly those specifically designed for children – offers hope for millions like Francis. With 17 vaccine candidates in the pipeline, a breakthrough in TB prevention is on the horizon. Yet, these advancements will only have the reach needed with adequate funding and support.

This is a pivotal moment for Canada to step up.

Canada has both the means and moral imperative to turn the tide against TB. This World TB Day is a reminder that we need bold policy and stronger financial commitments to drive meaningful change and build a future where every child has the chance to thrive in communities like Inawabui, unburdened by the shadows of this disease. The time for action is now.

Although Francis was cured of TB, his treatment was long and painful. No child – or parent – wants to be in this position. And we know they don’t have to be.

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