Dr Grania Brigden
Director, Tuberculosis Department, The Union
The COVID-19 pandemic is set to eliminate many years of progress against the HIV and TB epidemics. Children and adolescents are particularly vulnerable in the face of such a setback.
Before the pandemic hit, roughly a million children developed TB each year and a quarter of them died. Children with TB die from the disease at disproportionate rates. They respond well to commonly used treatments, with less than 1% mortality among children who receive treatment. However, of every 10 children who died from TB, nine of them had not accessed treatment and care.
Neglect of children with TB demands global attention
The widespread neglect of children with TB constitutes a human rights violation that demands urgent attention from the international community.
Children have every right to such treatment. This right is enshrined in numerous international legal frameworks, including the Convention on the Rights of the Child and the International Covenant on Economic, Social and Cultural Rights.
The widespread neglect of children with TB constitutes a human rights violation that demands urgent attention from the international community.
Over the last two decades, legal activists have effectively used human rights law to make healthcare provision more equitable, regardless of social, economic, ethnic, cultural, or other special status. Unsurprisingly, many of the precedents concern HIV treatment, reflecting the pioneering role of activists in expanding access to care.
The same imperatives also compel the treatment of TB — as affirmed by precedents from national courts and international tribunals. These include the Committee on the Rights of the Child, the European Court of Human Rights (ECHR), and the African Court on Human and Peoples’ Rights.
We can prevent TB in children everywhere
Preventive therapy is particularly important in children given their risk of developing TB disease if they do not access preventive therapy. Working with health authorities and community health workers in Uganda, The Union has proven that it is feasible to use clinical symptoms to see if children, with or without HIV, are sick with TB and then provide them with appropriate care.
The results are very positive. When we started, only 5% of children exposed to TB were getting preventive therapy. In just two years, it increased from 5% to 74%. We tested a similar approach in West Africa and had similar results. We continue to work with ministries of health to scale up these successful approaches.
This World AIDS Day let’s look to the inspiring precedents set by the HIV/AIDS community and redouble our efforts to ensure that all children and adolescents, everywhere, can realise their right to effective TB prevention, treatment and care.