13 November 2012

South Africa: Tutu TB Research Centre Wins Major Award

The Desmond Tutu TB Centre (DTTC) at the University of Stellenbosch will today receive an international award for its ground-breaking research into childhood TB and for its pioneering community-based approaches to TB and HIV care.

The U.S. $65 0000 Kochon Prize is awarded annually for the past six years to persons, institutions or organisations that have made a highly significant contribution to combating TB, a disease that is curable but still causes the deaths of three people every minute.

This 2012 prize was announced at the World Health Organisation's Stop TB Symposium, an annual event at the World Conference of the International Union Against Tuberculosis and Lung Disease.

Professor Anneke Hesseling, director of the paediatric TB programme at DTTC, accepted the award this morning in Kuala Lumpur.

"This prize is a wonderful recognition of our center's work in childhood TB over the last two decades and indicates the unique contribution made, cumulatively, by individuals in our group over the years. More importantly, this prize highlights the importance of childhood TB, which has been neglected for many decades," said Hesseling.

She added that childhood TB was an indication of how well we are doing with our overall TB control strategy.

TB in young children indicates recent TB transmission from adults to children, often at the household level, and is an indication of failing TB control among adults with TB, who typically transmit the organism.

Childhood TB also represents a significant burden of disease in high-burden countries such as South Africa, where almost 15% of all TB cases occur in children.

Since young children are more prone to a severe form of disease, such as TB meningitis, often with poor outcome, TB in young children can be a very serious disease, causing considerable morbidity and mortality.

Hesseling believes that for the first time, there seems to be hope in the fight against childhood TB.

"We have more emphasis on childhood TB from WHO and from public health programs which have traditionally only focused on adult infectious TB cases. Developing countries are writing guidelines and are implementing care for childhood TB while child-friendly TB drugs are being developed. New diagnostic tools are being developed; such tools should also specifically consider the needs of children, which remains a challenge," said Hesseling.

However, a new, more effective TB vaccine is urgently needed if there was any hope of winning the battle against childhood (and adult) TB.

Several new TB vaccines are currently being evaluated, including in South Africa, and all these trials include children.

New TB drugs are being evaluated to treat drug-resistant and susceptible forms of TB in adults and there are plans to also test these and make them eventually available in children.

"The biggest current challenge for TB control in children is that we have good knowledge, but that implementation is lagging behind – the 'implementation infidelity' phenomenon," Hesseling added.

Asked what items she would place on wishlist, Hesseling listed:

  • Increased political commitment for the prevention and treatment of childhood TB at programmatic level
  • An effective and safe vaccine to prevent TB in children.
  • The use of more family-friendly integrated ways to address both TB and HIV at the household and community level
  • Funding and research to generate new child-friendly accurate TB diagnostic tests in children
  • Effective and safe, shorter treatment regimens to prevent and treat TB in children

Hesseling ascribes the growing international interest in childhood TB over the past five years to the fact that the HIV research community now recognises that TB and HIV are inextricably linked, and the fact that childhood TB has been placed on the international TB control and advocacy agenda. She added that attention was also increasingly given to the design and implementation of very rigorous high-quality research for childhood TB, which is impacting on policy and practice, but also on the awareness of childhood TB in the international research funding community.

"We have a long way to go in this regard, but for the first time, there is a feeling that 'childhood TB is coming of age'," she said.

Dr Lucica Ditiu, Executive Secretary of the Stop TB Partnership said it was shameful that every day, across the world, 200 children die of tuberculosis.

"This is absolutely shameful, considering that we are in 2012, and it costs less than 3 cents a day to provide preventive treatment and 50 cents a day to provide treatment that will cure the disease. But children are often forgotten. The Desmond Tutu Centre has been at the forefront of organisations fighting to end the tragedy of TB in children," said Ditiu.

The Desmond Tutu TB Centre has established a number of outreach projects in areas where research is conducted; operating on the principle that research should be integrated with the services delivered by the Department of Health. It also established and runs the world's first international childhood TB training programme.

The scientific body of work on childhood TB produced by the centre's researchers includes more than 300 articles on the epidemiology, prevention, diagnosis and treatment of childhood TB. This work has engendered ten international policy documents on childhood TB, creating a robust evidence base for addressing childhood TB.

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