Every year, the World Tuberculosis (TB) Day is marked on March 24, to commemorate the day in 1882 when Dr Robert Koch announced his discovery of Mycobacterium tuberculosis – the organism that causes TB disease, and to raise awareness of the public about TB.

Tuberculosis is still the leading cause of death from a single infectious agent worldwide, killing more people than HIV and COVID-19. Each day, nearly 4000 people die from TB, and close to 28,000 people fall ill with this preventable and curable disease. The theme for the World TB Day this year is ‘The Clock is Ticking’, which conveys the sense that we are running out of time to take proactive measures to end the global TB epidemic. To commemorate World TB Day 2021, Dr Esin Nkereuwem, Professor Beate Kampmann and Dr Toyin Togun of the Childhood TB research group at the Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine (MRCG at LSHTM) have published a new comment  in The LANCET. The invited comment highlights that children bear the brunt of the global TB problem. In 2019, an estimated 192,000 children died from TB, and 568,000 “missing” childhood TB cases were neither diagnosed nor adequately treated.

The comment further shows that the COVID-19 pandemic may have worsened the situation due to the disruption of TB services worldwide. The authors propose that as countries begin to recover from the COVID-19 pandemic, there should be a substantial expansion of contact screening of children to identify more cases of the disease in the early stages and provision of TB preventive treatment to eligible children. Additionally, they recommend innovative community-based approaches to find childhood TB cases since research has shown that children most often acquire TB infection outside the household. They also emphasise that to end the global TB epidemic as planned by 2030, improved diagnostic tools and new vaccines that perform better than the 100-year-old Bacillus Calmette-Guérin vaccine are urgently needed.

In a joint statement, the authors of the LANCET comment stated that, “We have 10 million new TB cases each year, and 10 years left to meet our target of a world free of TB. We are running out of time. It is time to hold our global leaders accountable for their commitments. No child deserves to die from this curable and preventable disease. We will not go anywhere near the End TB Strategy targets if we continue at the current pace, be it for adults or children - the clock is ticking indeed!” The next few years will be crucial in the tuberculosis response, and it will take sustained efforts by many stakeholders to achieve the internationally agreed targets by 2030.