MUMBAI: The fight against pediatric TB acquired an edge on Wednesday when the World Health Organisation (WHO) unveiled strawberry- and raspberry-flavoured medicines customised for children, at a conference on lung health in Cape Town, South Africa. This is the first time that a fixed dose has been customised for children who were so far given regular TB pills in halves or crushed manner.

Significantly, the innovation has a Mumbai angle: Andheri-based Macleods Pharmaceuticals Ltd has been roped in by the WHO and TB Alliance to manufacture the new fixed dose combination for children. Mumbai is believed to be the TB capital of the world with over 30,000 new patients diagnosed every year. Of these, around 7% to 9% are under 14 years of age.

"Syrups will no doubt make it easier for mothers who had to struggle to crush tablets (which are bitter) and feed them to their children," said Mumbai’s TB control officer Dr Daksha Shah, who is at the Union’s World Conference on Lung Health in Cape Town. "The flavoured medicines will increase compliance among children,’’ she said, adding that 2,440 out of 31,207 patients diagnosed with TB in Mumbai were children.

Vijay Agarwal of Macleods Pharma told TOI that the new medicines were developed with the support of TB Alliance, a not-for-profit organisation that is working towards reducing TB cases to zero by 2030. "Once the paperwork is done, it will take us 10 weeks to roll out the consigments," said a company official.

Pediatric dosages for TB became an important issue in 2010 after doctors across the globe highlighted that children don’t recover as well because they are not given a consistent or fixed dose. The WHO, which estimates that TB kills 400 children across the world every day, then acknowledged that children needed special TB dosages, and appealed to manufacturers to work on this segment. Yet it took the world public health leaders three years to work out the right dosage for children and rope in manufacturers. TB affects 1 million children every year and 1.4 lakh die of it.

"If we are to end the TB epidemic by 2030, we must bring children with TB out of the shadows and ensure they are properly diagnosed, treated and cured," said Dr Mario Raviglione, WHO director of the Global TB Programme, speaking at the Cape Town launch. "The new fixed-dose formulations for children will offer hope for the 400 children who needlessly die of TB each day. Urgent action is needed to ensure these medicines reach those in need and rapidly improve child survival from TB."

The pediatric dosage launched on Wednesday isn’t new; it’s merely a fixed dose combination of the three most commonly used drugs to treat drug-sensitive TB (rifampicin, isoniazid, and pyrazinamide). "These are not new drugs, but rather improved formulations that are dissolvable and flavoured so that they are simple for providers and parents to administer and easy for children to take," said a press release sent by TB Alliance. "The formulations are in the process of being prequalified by WHO but are now available under the WHO’s Expert Review Panel mechanism," said the release.

The new medicines will help cut down the death rate. "Splitting TB pills, which gives the medication a bitter taste and usually results in imprecise dosing, makes the treatment journey even more difficult for children and their families," it added.