Open Letter to WHO: Time to report preventive TB therapy for children

On World TB Day, members of the global childhood TB community sent an open letter to the World Health Organization requesting they include the number of children under the age of five and the number of children with HIV started on preventive TB therapy in the annual Global Tuberculosis Report by 2016.

On March 24, 2015 policy makers, academics, clinicians, public health workers, and advocates sent an open letter urging the World Health Organization (WHO) to start asking countries to report the number of children screened for, started on, and completing preventive TB therapy.

The letter specifies three reasons for the importance of reporting on the number of children placed on preventive therapy:

• WHO and almost all national TB programs recommend that, following the identification of an infectious TB case, vulnerable child contacts (children less than five years old or with HIV infection) should be identified and, following screening to rule out TB disease, offered preventive therapy.  Yet, no one is tracking progress on country-level implementation of preventive therapy in children.

• Asking countries to report on the number of children started on preventive therapy each year sends a strong message that TB prevention in children is an important programmatic intervention and that routine monitoring data should be collected and reported to the global health community.

• Much of the burden of TB is among those who have been infected but are not yet sick. In order to reflect the true epidemiological situation, the pediatric numbers reported by the WHO must include all children affected by TB, including those exposed to TB and those receiving preventive therapy.

The letter acknowledges the challenges programs face in collecting data, and the demand placed on the health care workers and program personnel who track this information, analyse these data, and complete these reports. However, country programs must be encouraged to address and report on TB infection and preventive therapy in children to meet the ambitious goals set forth in the WHO’s End TB Strategy.

The letter requests a deadline of 2016 for the WHO to have laid all of the necessary groundwork—including issuing country guidance on measurement and evaluation for these new indicators—and to include the aforementioned figures for children on preventive therapy in its annual Global Tuberculosis Report.

To read the letter, click here.