Scaling up and improving access to ambulatory and paediatric TB care in Central Asia and Eastern Europe

Paediatric TB is an indicator for the current control of TB in the general population, since children with TB act as a future reservoir for the disease – there are reasons enough why new approaches to paediatric TB care should be integrated into every TB project and National TB programme.

So far, diagnosing and treating children for TB are particularly difficult, as there are no appropriate diagnostic tools, and no commercially available paediatric drug formulations.

These issues were at the core of the symposium titled “Scaling up and improving access to ambulatory and paediatric TB care in Central Asia and Eastern Europe”, held at the beginning of December in Dushanbe, and hosted jointly by MSF and the Ministry of  Health of Tajikistan. More than 100 participants, including 30 Ministry of Health representatives from across the Central Asian and Eastern European region (including Tajikistan, Russian Federation, Uzbekistan, Kazakhstan, Kyrgyzstan, Georgia and Abkhazia, Armenia and Ukraine) gathered to share experiences,  challenges and best practice for scaling up access to outpatient TB care and the diagnosis and treatment of TB in children, particularly drug-resistant  TB (DR-TB), whose high infection rates across the region are a major concern.

After MSF Regional TB symposia in Tashkent, Uzbekistan in 2011 and Bishkek, Kyrgyzstan in 2012, the symposium in Tajikistan represents the next step in strengthening cooperation among the main stakeholders as well as for adopting, disseminating and implementing paediatric TB guidelines across the region.

Read the article Children With TB Must Not Be Neglected here

The Dushanbe Declaration

All participants at the symposium agreed on the ‘Dushanbe declaration’, calling for a commitment to demonstrate the political will and ambition to attain “zero TB deaths”, which can only be achieved with a measurable government-led programme of investment in TB services, equipment and training. The declaration also calls for a commitment to develop viable new regimens with new drugs that are less toxic, more effective, can be taken orally, and for a shorter time-period, as an important step towards tackling the disease, together with a clear will to treat patients on an outpatient basis from as early as possible, as part of a patient-centred model of care.



Download the Dushanbe Declaration

Watch the video: The Final Frontier

An historic opportunity exists to tackle the escalating drug-resistant tuberculosis (DR-TB) public health emergency. Yet, the global response barely touches the surface of the problem. MSF works at the front-line of the DR-TB crisis in 21 countries around the world. 'The Final Frontier' shares our experience and learning in three areas. Parts of this series were presented at the symposium, here you can watch the full series.

Part 1: Global growing health crisis

Part 2: Evidence for improving patient outcomes

Part 3: Historic opportunity for a new treatment regimen

Previous Regional TB symposia

Have a look at the documentation websites of previous MSF Regional TB symposia:

2011 in Tashkent, Uzbekistan: Uniting to Scale up TB Care in Central Asia

2012 in Bishkek, Kyrgysztan: TB Care - A Patient Centred Approach

TB Manifesto

People with drug-resistant TB and their medical providers worldwide call for urgent change in the treatment and diagnosis of DR-TB.

Show your support for people living with MDR TB, share their call for better treatment & tools, visit and sign the DR TB Manifesto.