09 December 2019

Activist concerned about lack of suitable TB medication for children

Drug-resistant tuberculosis (TB) is difficult enough for adults to cope with, but in the case of children it is even worse.

Busisiwe Beko is an activist who has survived drug-resistant TB – with first-hand experience of the challenges facing parents of children who have the disease.

"I was diagnosed with drug-resistant TB in 2006, together with my child who was five months old at the time. We both started treatment together. It was bad enough for me, but even worse for her."

Many challenges

Beko explains that they had to take large amounts of medication for a period of two years before they were finally TB free. "She had to endure the same pain I went through with the injections we had to take from Monday to Friday. Apart from that we also had to take 20 tablets each day. For my daughter to get admitted to a hospital was a hassle. Because of a long waiting list, it took more than four months for her to be diagnosed by a specialist."

The Cape Town-based TB counsellor for international humanitarian health aid organisation, Médecins sans Frontières (MSF), also known as Doctors Without Borders, says that the issue of getting diagnosed isn't the only challenge faced by parents with children who have TB.

"It was a challenge when she started treatment, and we still don't have a child-friendly regimen of drug-resistant TB treatment. I still remember that I had to crush the tablets for my child and put them in water to dissolve."

Parents in the same situation as Beko receive adult-size tablets, which they have to divide into doses suitable for children, putting them at risk of an under- or overdose.

Advancements made

Alison Best from TB HIV CARE's communications unit says that a paediatric formulation TB treatment was actually launched in 2015.

"The child-friendly TB treatment was developed by TB Alliance and was launched at the 46th Union World Conference on Lung Health in Cape Town."

Several countries have since gone ahead and rolled out the treatment and, as of this year, a million courses have been dispensed in 93 countries.

According to Best, getting the formulation approved was a threefold struggle in the country:

"The South African Health Regulatory Authority (SAHPRA) was undergoing a period of organisational transition, and there appeared to be a general backlog in decisions. Children with TB are generally not infectious, and may therefore be perceived as a lower priority. Children rely on adults to raise and advocate issues that affect them, and thus far we have been failing them on this issue," she says.

She also adds that the regulator approved the paediatric formula in late 2018, and the next step is for the National Department of Health to put out a tender for the medication.

Catching up

Davis Mahlatji from SAHPRA says that the organisation is dealing with a backlog in the registration of health products.

"In 2018, SAHPRA became operational, and started to deal with immediate issues like backlogs and interventions." 

The regulator also stated that the formulation of medication for children is an area that they want to prioritise.

"Today, when a product comes to market, we ask manufacturers about paediatric administration. We want to make sure that they develop paediatric dosage."

– Health-e News

Image credit: iStock