A silent crisis is unfolding, and it's stealing the breath of our children. Tuberculosis (TB), a curable disease, is still devastating young lives, with a staggering 43% of children with TB missing diagnosis and treatment in 2024. But there's a beacon of hope: new findings from Doctors Without Borders/Médecins Sans Frontières (MSF) show that the World Health Organization's (WHO) treatment decision algorithms could dramatically change the game. This is a call to action for governments worldwide.
Published: Nov 18, 2025
Updated: Nov 18, 2025
At the World Conference on Lung Health, MSF unveiled data from their operational research, highlighting the benefits of using the WHO-recommended algorithms for diagnosing TB in children. These algorithms, which guide physicians in starting TB treatment based on symptoms even without lab tests, could nearly double the number of children receiving life-saving treatment. The study, known as Test Avoid Cure Tuberculosis in Children (TACTiC), evaluated these algorithms in 1,846 children under 10 years old across five countries: Uganda, Niger, Nigeria, Guinea, and South Sudan. The study included children facing severe acute malnutrition and those living with HIV. MSF's data shows the WHO algorithms correctly identified the majority of children with TB and, on average, doubled the proportion of children who could start TB treatment. MSF findings further showed that the introduction of the WHO algorithms supports healthcare workers in the diagnosis of TB in children, and that they are feasible to use. At the same time, they also increase parents’ satisfaction with timely TB care their children received.
"Our findings prove that WHO’s treatment decision algorithms, for which we do not need lab test results to initiate TB treatment in children, work in real-world settings and can potentially save many more children’s lives if implemented. The science is clear–what’s now missing is the political will to put it into practice," says Helena Huerga, physician and principal investigator of MSF’s TACTiC research study.
"Before, health workers relied on coughing and as long as children weren’t coughing, they thought they didn’t have tuberculosis," says Angeline Dore, physician and focal point for the TACTiC project in Guinea. "The WHO algorithms now tell us not to rely on coughing, there are other signs for TB as well."
And this is the part most people miss...
An estimated 1.2 million children and young adolescents under the age of 15 fell ill with TB in 2024. The challenge? Traditional lab tests often fail in children. Sputum samples, needed for many tests, are difficult for kids to provide, and even when they do, the low levels of bacteria in their lungs can make detection impossible. The WHO's Global Tuberculosis Report highlighted that a shocking 43% of children with TB in 2024 missed diagnosis and treatment.
In 2022, the WHO updated its guidelines, recommending treatment decision algorithms for diagnosing TB in children, regardless of X-ray access. But here's where it gets controversial... Despite the WHO's recommendations, many countries haven't adopted these algorithms in their national guidelines or implemented them in healthcare facilities.
"Too many children with TB are still slipping through the cracks in the absence of effective diagnostic tools," emphasizes Helena Huerga. "Our findings prove that WHO’s treatment decision algorithms, for which we do not need lab test results to initiate TB treatment in children, work in real-world settings and can potentially save many more children’s lives if implemented. The science is clear–what’s now missing is the political will to put it into practice."
Recent funding cuts threaten to worsen the situation. MSF urges countries and agencies to ensure sustained funding for TB care, especially for children. Daniel Martinez Garcia, project leader of MSF’s TACTiC project, adds, "In addition to timely adoption and implementation of the WHO algorithms, policymakers, donors and implementers must also anticipate and plan for an increase in supply of medicines needed to treat children to ensure that all children who are diagnosed with TB can access TB treatment without any delay."
What do you think? Are governments moving fast enough to implement these life-saving algorithms? What more can be done to ensure every child gets the TB care they deserve? Share your thoughts in the comments below!
