Urgent Alarm Over Paediatric TB Medicine Shortage in Pakistan

Pakistan Faces Critical Shortage of Paediatric TB Medicines

The Pakistan Medical Association (PMA) has sounded an urgent alarm over the critical shortage of paediatric tuberculosis (TB) medicines across the country. Healthcare facilities report a near-total depletion of first-line TB drugs for children, leaving thousands at risk of incomplete treatment.

Pakistan carries the fifth-highest TB burden globally, making this shortage particularly dangerous. Experts warn that interruptions in treatment could lead to a catastrophic surge in drug-resistant TB, including multi-drug resistant (MDR) and extensively drug-resistant (XDR) strains.

The PMA highlighted that inconsistent treatment allows TB bacteria to survive and mutate, forcing families into years of toxic, expensive, and less effective therapies. Already, MDR-TB prevalence stands at 40 percent among previously treated patients, while XDR-TB carries a mortality rate of up to 31 percent.

Children are especially vulnerable. Without consistent medication, the risk of disseminated TB—where infection spreads to the brain or blood—rises sharply. If first-line drugs fail, children must endure second-line regimens lasting up to 24 months, often causing liver toxicity, anaemia, and permanent hearing loss.

The crisis stems not from a lack of manufacturing capacity but from systemic failures in procurement and distribution. Local pharmaceutical companies have produced TB drugs in the past, with one even receiving WHO prequalification in 2023. However, pricing disputes and frozen retail caps made production financially unviable, leading to reliance on imports.

The PMA has urged the federal and provincial governments to immediately initiate emergency imports of paediatric TB formulations. It also called for a transparent audit of drug stocks to ensure equitable distribution and prevent localised shortages.

Experts stress that unless urgent action is taken, Pakistan risks a public health disaster. The shortage of paediatric TB medicines is not just an administrative failure—it is a medical emergency threatening the lives of the country’s most vulnerable population.