Tuberculosis

Targets for ending Tuberculosis (TB) in children and adolescents, set at the United Nations high-level meeting (UNHLM) on the fight against TB, are very ambitious. Access to shorter and safer child-friendly regimens for prevention and treatment of drug-susceptible and drug-resistant TB is key to reaching these targets, as it facilitates the implementation of World Health Organization (WHO) recommendations. Optimization of child-friendly formulations of TB drugs forms also part of the key actions and milestones in the 2018 Roadmap towards ending TB in children and adolescents.

Despite major advances in this area – with child-friendly first-line fixed-dose combinations available since 2016 and child-friendly formulations of many second-line TB drugs available since 2018 – TB treatments for children are still unsatisfactory. Reaching consensus among stakeholders on priority paediatric TB formulations is key to ensuring that researchers, research funders, donors and manufacturers focus on the timely development of those formulations.

In February 2019, the WHO Global TB Programme convened the first Paediatric Antituberculosis Drug Optimization (PADO) TB meeting (PADO-TB1). PADO-TB1 brought together relevant stakeholders, including representatives of national TB programmes (NTPs), members of the Child and Adolescent TB Working Group, clinicians, researchers, community representatives and financial and technical partners. The meeting was a unique opportunity to discuss ongoing paediatric studies and emerging results, and jointly reach consensus on a list of priorities for paediatric TB medicines for which accelerated development and marketing is urgently needed. In September 2020, the PADO-TB1 priority list was reviewed (see Table 1). Reviews and updates of the PADO-TB list will be carried out on a regular basis in the future.

Priorities identified by PADO-TB have contributed to key processes such as the update of the invitation to manufacturers of antituberculosis medicines to submit an expression of interest for product evaluation to the WHO Prequalification Unit (PQ EoI).

PADO list

Rifapentine, 150 mg scored dispersible tablet

Rifampicin 100 mg scored dispersible table (tentative listing)

Moxifloxacin 100 mg dispersible tablet (palatable)

Pretomanid

Watch List

All compounds in or shortly entering phase II, with special attention to compounds that are more advanced in development (phase IIb/c), including delpazolid, sutezolid, GSK-656, quabodepistat, BTZ-043 and TBI-223.

Long-acting technologies (e.g. injectables, microarray patches) for TB medicines.

Oral dispersible film/strips of rifapentine-including products.

Contact

Annemieke Brands

Technical Officer - Child and Adolescent TB

Email: brandsa@who.int

Sabine Verkuijl

Medical Officer - Child and Adolescent TB

Email: verkuijls@who.int

Resources