Tuberculosis is a major unrecognized cause of disease and death in young children living in tuberculosis-endemic settings.1 Recent estimates suggest that nearly a million children develop tuberculosis each year, although accurate quantification of the tuberculosis disease burden in children is hampered by difficulties in establishing an accurate diagnosis.2,3 Tuberculosis case loads are highly concentrated in areas affected by poverty and social disruption, but all countries are affected owing to increased international travel, population migration, and refugee resettlement.4 Awareness that children have a large tuberculosis burden that is preventable and treatable has increased following calls to action in 2010 and 2011.5,6 World Tuberculosis Day was dedicated to children in 2012, a new Roadmap for Childhood Tuberculosis launched in 2013,7 and a revised Guidance for National Tuberculosis Programmes on the Management of Tuberculosis in Children published by the World Health Organization in 2014.8 Despite improved guidance and policies, implementation remains poor with major policy-practice gaps, especially regarding the provision of preventive therapy.9