What were the challenges you faced in launching them?
Dr Immaculate Kathure: "We had to deal with the current formulation stocks that were in the country and in the pipeline. The commodity management team accurately forecasted the needed quantities and an appropriate time to roll-out the new medicines without too much wastage. There was also need for massive sensitization of healthcare workers at the various levels and to ensure they were knowledgeable on how to use the new medicines. As the time period for this was short, it was addressed through training of the county health teams who in turn were supported to simultaneously train their healthcare workers. This required a huge resource/investment that were graciously availed by the USAID and the TB Alliance. The sensitization programmes are still on-going."
How many children with TB will benefit from this programme?
Dr Immaculate Kathure: "Starting from 1st October, 2016 all children with TB, whether in the public or private sector, will receive the improved formulations. Children already on TB treatment using the former formulations prior to 1st October will continue and finish on the old ones. Those starting on treatment from 1st October 2016 onwards will initiate on the new medicines. But there is room for special considerations where necessary. The same policy will apply to those in the private sector. Currently 81% of all children on TB treatment are in the public sector, while the rest are in the private sector. For all children with TB, treatment is given free whether in the public or private sector."
Will this programme have any additional financial burden on Kenya?
Dr Immaculate Kathure: "The improved formulations will ease, and not add, to the financial burden of the government. This is because the current regimen was a complex one - with need for more storage space, higher transport costs and more costs at portal clearance since the commodities were more. The new formulations were procured using the government of Kenya's funding from WHO's prequalified supplier - Macleods, (an Indian pharmaceutical company). Further procurement will be supported by the government and by partners. We do not foresee any problems now in the implementation of the programme."
What needs to be done for better TB control in children?
Dr Immaculate Kathure: "Now that the child-friendly medicines are here, we need to intensify our efforts to find all children who may be exposed to TB and screen them. Those found to have TB should be promptly started on treatment; while those under 5 years exposed to TB, but without disease, should receive Isoniazid preventive therapy (IPT) to protect them from TB. All caregivers of children with TB need to strictly adhere to the advise of the healthcare workers during diagnosis and treatment. Together we can bring childhood TB from the shadows. Action starts with us!"
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