Governments and international donors must invest more in diagnosing, treating, and preventing tuberculosis (TB) in children, said Doctors Without Borders/Médecins Sans Frontières (MSF) today. No child should suffer or die from a disease that is preventable and treatable.
“In an already underfunded TB response, children are pushed further to the back of the line when services are disrupted by aid cuts, conflict, or displacement,” said Cathy Hewison, MSF’s TB platform lead. “The tools to diagnose and treat children with TB exist — even if imperfect — yet only half of the children who have TB are diagnosed or treated. For a truly global TB response, children cannot remain an afterthought. They must be prioritized now.”
TB disproportionately affects children
According to the World Health Organization (WHO) Global Tuberculosis Report 2025, 1.2 million children under 15 fell ill with TB in 2024. Children continue to be disproportionately affected by TB, accounting for 14.2 percent of all related deaths. The WHO report states that a staggering 43 percent of the children with TB were not diagnosed and could not access treatment, showing no improvement from previous reports.
Children with TB already face the widest gaps in care and are the first and most vulnerable to disruptions in health care services due to global aid funding cuts, uncertainty around funding streams, conflict, and displacement.
MSF teams frequently see children with TB whose treatment is delayed due to a lack of or inappropriate diagnostic approaches, or because physicians simply don’t think that they might have TB. In Mueda, Mozambique, Francisco, an 11-year-old boy, began showing signs of TB in July 2024, yet his symptoms were overlooked for months. It was only in March 2025 that he finally started appropriate TB treatment, long after the first warning signs.
“At first, I noticed that my child was weak and had no appetite,” said Francisco’s father, Fernando Jorge Anasomia.“Initially, [doctors] didn’t do any tests. When tests were [finally] done, nothing showed up. They told us that the child had no disease. When we went to the hospital for the second time and had the tests done again, that’s when they told us that the child had drug-resistant TB. It took a long time to start treatment even though he started to feel ill eight months before.”
Treatment algorithms can mean the difference between life and death
One way we can get closer to reaching children missing out on TB diagnosis and treatment is by implementing WHO guidelines, specifically the treatment decision algorithms WHO recommends. These algorithms are guided scoring systems that allow health care workers to diagnose TB based on clinical symptoms alone. This can mean the difference between life and death in places where laboratory capacity is limited, as is the case in many places where the TB burden is high.
Based on recent MSF research conducted in five African countries (Guinea, Niger, Nigeria, South Sudan, and Uganda), the use of the WHO algorithms can nearly double the number of children who can be diagnosed with TB and subsequently begin lifesaving treatment.
“The impact of implementing the WHO treatment decision algorithms in Niger has been a catalyst for hope,” said Dr. Moussa Mamane Oumarou Farouk, TB focal point for MSF in Niger.
“In 2024 and 2025, nearly half of all the children under 5 years of age who were diagnosed with TB were in the five districts where MSF supports the implementation of the algorithms,” Dr. Farouk added. “Considering there are a total of 72 districts in Niger, scaling up these approaches across the country — together with the Ministry of Public Health and Hygiene — could significantly close the gap in diagnosing TB in children and preventing more avoidable deaths.”
To advance these efforts, MSF is currently running the Test Avoid Cure Tuberculosis in Children (TACTiC) project, which aims to innovate TB care for children by implementing the latest WHO recommendations and generating evidence on their effectiveness, feasibility. The project also includes advocating for their implementation at global and national levels.
MSF has been providing TB care for 30 years, working alongside national health authorities to treat people in diverse settings including conflict zones, under-resourced urban communities, prisons, refugee camps, and rural areas. In 2024, MSF treated 25,000 people with TB, including 1,500 patients with drug-resistant TB, in over 35 countries. Most patients were in Africa (68 percent) and Asia (30 percent).