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Open Access A bitter pill to swallow: the need for better medications for drug-resistant tuberculosis in children

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The large and growing access gap between the number of children who become sick with drug-resistant tuberculosis (DR-TB) and those who are treated for the disease each year represents a significant health systems failure. While there are multiple reasons why children with DR-TB are not diagnosed and treated, a serious challenge is the medications used to treat the disease. This paper presents three child DR-TB cases who were treated incorrectly; the cases are used to illustrate some of the problems with existing second-line medications. Challenges, including the perception that the drugs are more dangerous than the disease, lack of proper dosing recommendations and formulations, and the high cost of current treatment, all contribute to a perverse situation in which the most vulnerable pediatric patients are provided with a lower standard of care. This situation can be reversed with novel partnerships and training models, pharmacokinetic studies of the relevant drugs, increased collaboration, and dedicated funding, grounded in a rights-based approach to DR-TB in children.
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Keywords: access; children; drug-resistant TB; medication

Document Type: Research Article

Affiliations: 1: Harvard Medical School, Department of Global Health and Social Medicine, Boston, Massachusetts, USA 2: University Research Corporation, Mbabne, Swaziland 3: Access Campaign, Médecins Sans Frontières (MSF), Geneva, Switzerland 4: Manson Unit, MSF, London, UK 5: Baylor International Paediatric AIDS Initiative, Mbabane, Swaziland 6: TB Research Unit, Case Western Reserve University, Cleveland, Ohio, USA 7: Imperial College, London, UK 8: Global TB Childhood Programme, Baylor College of Medicine, Swaziland 9: Desmond Tutu TB Centre, Stellenbosch University, Cape Town, South Africa

Publication date: 01 December 2015

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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