Please sign the below letter directed to House Energy and Commerce leaders and Senate Health, Education, Labor, and Pensions Committee leaders to immediately allow the United States to procure pediatric TB medications through the GDF and ultimately to develop a pathway for FDA approval of dispersible pediatric TB drugs so they may be readily available here in the United States. The letter is open to organizations and individual signers. The deadline to join the letter is end of day July 15. For any questions, please contact Donna Wegner at dhwegener.ntca@gmail.com. _________________________________________________ Dear Senators Cassidy and Sanders and Representatives Guthrie and Pallone: On behalf of the undersigned organizations and individuals, we urgently request your support to ensure access to appropriate tuberculosis (TB) medications for children in the United States. Currently, children are treated with pills designed for adults, which have to be crushed or suspended in liquids in an inconsistent manner. While child appropriate formulations of pediatric TB medications are available in more than 123 countries around the world, they are not available to children in the United States because of regulatory and cost barriers. While FDA approval of pediatric TB medications is the ultimate solution, this will take several years and still lacks appropriate funding. We need an immediate solution and urge you to allow the United States to access these medications through the Global Drug Facility (GDF)—a bundled drug procurement mechanism that supplies quality-assured TB treatments and diagnostics to 165 countries worldwide. TB—a highly contagious airborne bacterial infection—is the world’s deadliest infectious disease. Each year more than 10 million people fall ill with TB around the world, including approximately 1.25 million children 14 or younger. In 2024 an estimated 1.23 million people died of TB including an estimated 174,000 children and young adolescents (<15 years). While often fatal if untreated, TB is curable with antibiotics. Although the United States has one of the lowest TB rates in the world, TB outbreaks continue to occur. Between 2017 and 2023, the United States had 50 large TB outbreaks, and in 2025 there were over 10,200 cases of TB in the United States. Recently, a large TB outbreak in Kansas resulted in nearly 70 people developing active TB. Of those individuals, 17 were children aged 15 years or younger—representing 24 percent of all cases in the outbreak. Unfortunately, in large TB outbreak cases in the United States, children 15 years and younger are often disproportionately affected, representing 15 percent of cases compared to 3 percent in smaller outbreaks. This is in part due to ongoing challenges to provide adequate treatment for children in the United States with TB. While most of the world has access to approved, high-quality, effective water-dispersible, flavored pediatric TB drugs, children with TB in the United States are unfortunately treated with arcane methods—with estimated amounts of adult medications being crushed and blended into yogurt, apple sauce, or other foods that the child will swallow. Efforts are underway to bring pediatric dispersible TB medications to the U.S. market directly; however, there is a lack of current funding to formulate and manufacture these products for FDA approval. Once funding is secured, this process will take years, and we need these drugs for our patients now. We are working with the GDF to allow the United States to procure these drugs for patients here at home, however, TB controllers and United States physicians are not allowed to use this drug procurement mechanism despite years of United States government funding support for the GDF. We ask that Congress work with us to immediately allow the United States to procure pediatric TB medications through the GDF or other countries with similarly stringent regulatory authorities and ultimately to develop a pathway for FDA approval of dispersible pediatric TB drugs so they may be readily available here in the United States. Thank you for your consideration. For any questions on this issue, please reach out to Erin Morton with the TB Alliance, at emorton@dc-crd.com. Sincerely,

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