Building on the experience in the WHO HIV programme, the inaugural paediatric antituberculosis drug optimization (PADO TB 1) meeting, which took place on 14 and 15 February 2019 at WHO headquarters in Geneva, aimed to establish a formal transparent process to reach evidence-based consensus among a variety of stakeholders regarding priority antituberculosis drugs and formulations for children. The meeting was attended by 45 participants, with six additional attendees participating remotely, and included representatives from NTPs from TB high burden and priority countries, clinicians, scientists, funding organizations, international organizations and technical partners.
During the first day, presentations covered the size and specifics of the paediatric anti-TB drug market, the concept of paediatric antituberculosis drug optimization, experiences with antituberculosis drug development and market-shaping and the current adult and paediatric TB research and clinical trial landscape, priorities and overview of drug development. Participants engaged in discussions on the PADO for TB mechanism and modus operandi in the context of complementary efforts in paediatric drug optimization as well as the process to reach consensus on short/medium and long-term priorities for the development of paediatric antituberculosis drugs and formulations.
On the second day, after providing additional background information on the PADO for HIV processes and priority list, participants broke up into three groups to discuss short/medium and long term priorities for a) treatment of drug-susceptible TB; b) treatment of drug-resistant TB; and c) treatment of latent TB infection (LTBI – both drug-susceptible [DS-TB] and drug-resistant TB [DR-TB]). A summary of the agreed priorities can be found in executive summary of the meeting report. This prioritization exercise was an important step towards development of and access to the most effective and safest medications in affordable, child-friendly formulations needed to reach the UN General Assembly High Level Meeting on TB targets for treatment and prevention in children.
The Sentinel project updated their Field Handbook to provide implementation advice on the new WHO Guidelines for Multi-Drug and Rifampin-Resistant Tuberculosis (available at https://www.who.int/tb/publications/2018/WHO.2018.MDR-TB.Rx.Guidelines.prefinal.text.pdf). This Field Handbook was developed by a global team of pediatric DR-TB experts, including several Child and Adolescent TB Working Group members and aims to provide practical advice for practitioners, programmes and policy makers on how the new WHO recommendations can be used to improve treatment for children with DR-TB. For more information on the Sentinel project, visit http://sentinel-project.org/.