Preface

This third edition (referred to as the 2023 Roadmap) of the Roadmap towards ending TB among children and adolescents is an update to the 2013 and 2018 versions. The 2023 Roadmap recognizes the progress made over the past five years and outlines priorities and key actions designed to accelerate progress towards the targets elaborated during the 2023 United Nations General Assembly High-Level Meeting on the fight against TB. Implementation of these key actions at the global, regional, national and sub-national levels in the context of Universal Health Coverage (UHC) is expected to find and treat more children and adolescents with tuberculosis (TB) disease or TB infection, to prevent TB, to improve treatment outcomes and prevent TB-associated disability.
The 2023 Roadmap retains the strong focus on TB in children, while also emphasizing the importance of addressing TB among adolescents, and for the first time, among pregnant and post-partum women. Adolescents also have high rates of TB and have specific age-related needs that should be considered to improve outcomes. The inclusion of pregnant and post-partum women reflects the heightened risk of TB disease in this group and the ability to improve the lives of mothers, their infants and other family members, by preventing or addressing TB.1 The 2023 Roadmap also recognizes the potential impact of climate change on poverty and diseases related to poverty – such as TB – and of possible future pandemics that may affect children and adolescents disproportionally, as was the case during the COVID-19 pandemic. Efforts to address pandemics and the health-related impacts of climate change need to consider these vulnerable populations.
The 2023 Roadmap is aligned with the 2022 World Health Organization (WHO) consolidated guidelines and operational handbook on the management of TB in children and adolescents. Its development has benefitted immensely from technical inputs by the core team of the Child and Adolescent TB Working Group throughout the process, and from additional inputs from the working group members and country representatives during a stakeholder consultation. To set the scene for the 2023 Roadmap, Ciara Goslett from South Africa shared her emotional story of surviving multidrug-resistant TB; we salute her bravery and ongoing advocacy efforts. We are also grateful to those who provided examples of the implementation of interventions to address TB in children, adolescents and pregnant and post-partum women that are included in text boxes.
WHO looks forward to continued collaboration with TB survivors, community, civil society, technical and financial partners to advocate and facilitate implementation of the key actions highlighted in the 2023 Roadmap. Every child and adolescent has the right to life and health, which are key principles highlighted in the Convention of the Rights of the Child. Children and adolescents are our future – together, we have an opportunity to improve their health, well-being and opportunities in life by preventing and managing TB.