2024 The Union World Conference on Lung Health

Despite ambitious commitments made at the United Nation high level meetings (UNHLM) on tuberculosis (TB) in 2018 and 2023, and increased attention on TB in children and adolescents in recent years, there are still critical gaps that remain to be addressed when it comes to ensuring adequate access to TB care for children and adolescents.

As highlighted in the World Health Organization (WHO) Global TB report 2023, an estimated 1.25 million children and young adolescents (0–14 years old) fell ill with TB in 2022 and 214,000 died due to this preventable and curable disease. Half of them (51%) were not diagnosed or not reported to national TB programmes. Thousands of children and young adolescents are therefore missed by health systems due to limited access to TB services and related logistical and financial challenges, as well as stigma. Weak implementation of integrated family- and community-centered services as well as lack of adolescent-friendly services are still a major barrier. In September 2023, Member States renewed their commitments towards ending TB, including in children and adolescents, and agreed to ambitious targets to be met by 2027, reflected in the political declaration arising from the 2023 UN HLM.

During the annual meeting of the Child and Adolescent TB Working Group in November 2023, WHO, in collaboration with the Child and Adolescent TB Working Group of the Stop TB Partnership, launched the Roadmap Towards Ending TB in Children and Adolescents third edition. This document outlines ten priority actions that need to be undertaken by key stakeholders to end TB in children and adolescents and to achieve the targets included in the political declaration arising from the 2023 UN HLM on TB. Progress can only be made if the key actions included in the Roadmap are fully implemented and this cannot happen without strong support from communities and civil society organizations (CSOs).

This Community Connect session will provide an overview of the progress towards the implementation of the Roadmap, one year after it was launched, identify key challenges related to implementation and discuss how CSOs and communities can play a key role in advocating for the implementation of the 10 key actions outlined in the Roadmap.

The main objectives of this session are to: 

• Discuss progress made towards implementation of the Roadmap 

• Share examples and experiences of the critical role that civil society can play in supporting the implementation of the key actions in the Roadmap, including ensuring key stakeholders’ accountability 
• Share reflections and ideas from relevant stakeholders on opportunities to accelerate the implementation of the 10 key actions in the Roadmap 

Session coordinator: Cosette Audi, Public Policy and Advocacy Officer, EGPAF

Each year more than 200 million women and persons become pregnant. Estimates suggest that 216,500 of them are diagnosed with TB disease, increasing their risk of poor maternal and pregnancy outcomes, including mortality, miscarriage, pre-eclampsia/eclampsia, low birthweight, and premature birth. Immune changes that occur during pregnancy make both pregnancy and the postpartum period a time when people — particularly those living in high TB burden settings — are at an increased likelihood of TB. Despite this, pregnant and breastfeeding populations are excluded from most TB therapeutics and vaccine research. As a result, this group is unable to access the full benefits of recent scientific advancements in TB, including the newer short-course prevention and treatment regimens.

In October 2023, the SMART4TB Consortium, the IMPAACT Network, and the WHO Global Tuberculosis Programme co-convened a meeting to launch a consensus building process on the inclusion of pregnant and breastfeeding people in TB research to improve the TB treatment and prevention options available to them. In conjunction, SMART4TB convened a meeting for representatives of affected communities to develop their own consensus on inclusion. This initial meeting has been followed by a year-long process, composed of five working groups: pre-clinical, therapeutics, vaccines, surveillance and advocacy.

This session will highlight the role of advocacy in driving the inclusion of pregnant populations in research forward. It will feature perspectives of advocates who have engaged in the SMART4TB and WHO pregnancy consensus process from across regions with high TB burdens. Additionally, it will share perspective from TB researchers on how advocacy informs their work. Finally, the session will provide a framework for engaging community advocates to advance equity in research.

Session chair: Cosette Audi, Public Policy and Advocacy Officer, EGPAF

Adolescents contribute to a considerable proportion of the global tuberculosis (TB) burden. However, TB services are generally not tailored to the unique needs of this population, leading to suboptimal access to and retention in care. This session will review up-to-date evidence on the health service needs of adolescents with TB, as well as a wide range of innovative adolescent-friendly services from diverse settings. The presentations will showcase key features and lessons learned, which can contribute to successful design and delivery of adapted services, as well as their integration into routine programming. At the end of the session, the audience will have a greater appreciation of the importance of adolescent-friendly care. Moreover, the audience will learn about different approaches to providing adolescent-friendly care, which they can apply in their own settings.

Session chair: Dr Martina Casenghi, Director of TB Program, EGPAF