‘CRIMINAL negligence’ is the phrase that jumps to mind when one considers the disturbing consequences of the government’s failure to ensure availability of lifesaving tuberculosis drugs for children. The Pakistan Medical Association this Friday flagged the severe shortage of essential paediatric TB medications across the country, warning that this may lead to a “catastrophic surge” in drug-resistant TB in affected children. Unavailability or interrupted availability of critical medicines allows TB to survive and possibly mutate into multi-drug-resistant and extensively drug-resistant variants, the PMA notes, warning that mortality rates of extensively drug-resistant TB are as high as 31pc. The Association adds the chilling note: “Children are uniquely susceptible. Without consistent medication, the risk of disseminated TB — where the infection spreads to the brain or blood — increases exponentially. If first-line drugs fail, children are forced onto second-line regimens lasting up to 24 months, associated with liver toxicity, anaemia and permanent hearing loss.” This is the cost of negligence that our children are expected to bear.

Children’s health and even lives have been put at stake due to poor policymaking. The PMA notes that TB drugs for children stopped being produced as it became economically unviable for pharmaceuticals to do so because of government-imposed price caps. Though subsequent deregulation has led to many essential drugs re-entering production, many medicines for sick children are still not available. The PMA is now warning of a national health emergency that we are not equipped to handle, and has appealed to the federal and provincial governments to intervene before the crisis becomes permanent. Decision-makers must act on the warning. Pakistan must import the necessary drugs immediately and mobilise its health machinery to plug the gaps in treatment available to children. Strict and visible action must also be taken against negligent officials. This is a moral failure that needs to be addressed at the highest level.

Published in Dawn, March 15th, 2026