In diagnostics – For children under 10 years of age, who cannot produce sputum, often invasive diagnostic methods like gastric lavage or nasopharyngeal aspiration are used to get sputum sample which is quite uncomfortable and at times painful for patients. MSF is asking for the initiation and expansion of non-invasive methods of diagnosis like stool GeneXpert which includes the use of stool specimen that is easier to obtain from children (stool).

In treatment – MSF appeals to India's National TB Elimination Programme (NTEP) to facilitate use of paediatric formulations of Bedaquline (BDQ) and Delamanid (DLM) for children below 5 years of age, which also includes Drug Controller General of India’s (DCGI) approval on 25mg DLM.

There must be access to adequate quantities of pediatric formulations, shorter injectable-free regimens for children and adolescents living with DR-TB. As a priority, DLM for all children, including those under 5 years of age, should be made available in routine programmes.

At MSF clinic, pediatric formulation of BDQ and DLM via compassionate use is provided to eligible children under 5 thus ensuring injectable free regimens. BDQ and DLM are well tolerated by this vulnerable group though currently few in number-13 patients, treatment success was 75%.

With successful treatment outcomes recorded through activities in Mumbai, no child should get injectables for DR-TB unless no other effective oral drugs are available to be a part of the regimen based on resistance pattern. Injectables are painful and toxic for both adults and children.