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Progress in

Uptake of
Pediatric
Medicines
Shelly Malhotra and Joanna Breitstein
TB Alliance

Childhood TB: Hiding in the shadows


1 million children develop TB each year. 53
million carry the TB infection, but dont show
symptoms (yet).
140,000 children die each year of a disease that
can be prevented & treated.
Child health and survival is improving, with
fewer deaths from diseases such as malaria and
pneumonia. But TB lingers, and lacks
attention/resources to the problem.

Sub-optimal treatment for children


Lack of consideration of the unique needs of children
In 2010, WHO changed their dosing
recommendations for children with TB,
but manufacturers were unresponsive
With no appropriately-dosed, childfriendly TB medicines, providers had to
cut, crush, or combine tablets to
achieve desired dose
Poor tasting medicines made
administration challenging and caused
vomiting, decreasing adherence

Inconsistent administration from


country to country has meant there is
no unified response to the problem

Child-Friendly FDCs Now Available


Simple to use, affordable, and appropriately dosed

With investment from UNITAID and others,


and together with WHO and partners, TB
Alliance has announced availability of childfriendly medicines in the correct doses
o Rifampicin 75 mg + Isoniazid 50 mg +
Pyrazinamide 150 mg
o Rifampicin 75 mg + Isoniazid 50 mg

Available through the Global Drug Facility


(GDF) and directly through the manufacturer
(Macleods)
WHO Prequalification anticipated in mid 2016
The average treatment cost is $15.54

Improving treatment for children

From Availability to Uptake


Progress in Introducing New Child-Friendly FDCs
Registration:
Filings underway, with accelerated pathways being sought in some countries
Registration secured in India and Cote dIvoire already

Policy:
Policy guidelines adopted in 19 of 22 high burden countries

Funding:
Countries have proactively budgeted for pediatric procurement
Gaps possible in supporting costs related to product transition

Procurement:
Underway with 30,000,000 tablets ordered to date
Technical support being provided to facilitate phasing out of old treatment and
phasing in of new treatments

Adoption-ready: Speeding access to new products


Everyone can play a role
GOVERNMENTS/HEALTH PROGRAMS

COMMUNITY/PROVIDERS
- Integrate questions about TB into child health
screening
- Ask about availability of child-friendly
treatments

- Scale up contact-tracing

- Include Child TB in strategies and budgets


- Fast-track product registration
- Implement current guidelines
- Develop plans for phasing in improved
treatments

- Scale-up effective childhood TB interventions

ADVOCATES/CIVIL SOCIETY
- Encourage government to
register and adopt new products
- Advocate for scale up of
effective childhood TB
interventions

EVERY CHILD
HAS ACCESS
TO THE NEW
PRODUCT

DONORS
- Fund new treatments and
introduction related costs

- Support technical assistance to


facilitate transition

Theres still work to be done

Its time to get


Louder Than TB!

Louder Than TB Campaign


Global leaders are joining forces with leaders from the private &
public sectors and media to:
Raise awareness of childhood TB as a critical issue on the
maternal and child health and survival agenda and as part
of the Global Goals;
Promote the need for integration of TB into other
maternal and childhood services at the country level to
find children with TB and treat them with the best
solutions available;
Ensure the most vulnerable have access to TB prevention;
Drive further investment in innovation of new TB drugs,
diagnostic tools, and vaccines
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Come Join Us on World TB Day & Beyond

Introduction of Child-Friendly TB Medicines

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Come Join Us on World TB Day & Beyond

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Heres how you can raise your voice


Visit LouderThanTB.org to learn more!
Join our Coalition of Partners!
Post, share, follow the Campaign to raise the volume around
childhood TB on World TB Day, March 24th
Stay tuned for future initiatives!

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