Medical personnel assess a child for tuberculosis as part of a research study in Mbarara. Uganda, 2024. © Stuart Tibaweswa
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MSF calls for sustained investments to address tuberculosis in children

Children with tuberculosis are the most at risk in the global health funding crisis

Ahead of World Tuberculosis Day, Doctors Without Borders/Médecins Sans Frontières (MSF) calls on all countries and international donors to prioritize and ensure sustained investments for diagnosing, treating and preventing tuberculosis (TB) for all – especially children, who remain the most at risk.   

Every three minutes, a child dies of TB. The World Health Organization (WHO) estimates that 1.25 million children and young adolescents (newborn to 14 years old) fall ill with TB each year, but that only half of these children are diagnosed and treated. In 2022, the WHO revised its guidance for the management of children and adolescents with TB, which, if adopted and implemented, could drastically improve care and save lives. The MSF project TACTiC – Test, Avoid, Cure TB in Children, is implementing the new WHO recommendations in MSF programs in over a dozen countries in Africa and Asia and has already documented an increase in children diagnosed with TB and put on appropriate treatment.  

However, MSF is gravely concerned about the recent United States funding cuts. The U.S. is the largest financial contributor for TB programs, accounting for half of all international and bilateral donor funding, according to the WHO.   

“We cannot afford to let funding decisions cost children’s lives.” 

Ei Hnin Hnin Phyu, physician and medical coordinator working with MSF in Pakistan

“For years, we have witnessed the deadly gaps that children face to access diagnosis and treatment for TB in countries where we work,” says Cathy Hewison, physician and head of MSF’s TB working group. “Children at risk of having TB are often overlooked, either going undiagnosed or facing delays in diagnosis. Now, with the recent U.S. funding cuts, these gaps in identifying and treating children with TB will only widen further, which threatens to rollback years of progress in TB care. We urgently call on all countries and international donors to step up and ensure sustained funding for TB care for all, especially young children. No one should die or suffer from this preventable and treatable disease.”  

MSF teams in Sindh province, Pakistan, are witnessing the U.S. funding cuts leading to the disruption of community-based services. In a country with a high burden of TB, these services play a key role, especially true in active screening of people in the community. Active screening increases the number of people diagnosed, the screening of families at high risk and the provision of TB preventive treatment for children.   

One child dies of tuberculosis every three minutes, according to WHO. 2025. © MSF

“Children are already highly susceptible to TB and we are worried the U.S. funding cuts that have impacted the community-based services will have a disproportionate effect on children, leading to more children with TB and more avoidable deaths,” says Ei Hnin Hnin Phyu, physician and medical coordinator working with MSF in Pakistan. “We cannot afford to let funding decisions cost children’s lives.”  

Children with weakened immune systems, for instance due to HIV infection or malnutrition, are the most vulnerable. So they will be disproportionately affected by disruption of TB, HIV and nutrition treatment and services.  

Children with TB are often excluded from research and development trials being carried out on new tools for TB. The recent U.S. funding cuts have halted numerous clinical trials, setting back TB research and innovation – with many of them being critical for children with TB. This is a major step back in the fight against TB, as it delays the development of much-needed diagnostics and treatments for children.  

MSF calls on the pharmaceutical industry and international donors to ensure sustained investments in the development and evaluation of medical tools that can improve TB care for children.