By Whoopi Goldberg, UNICEF Goodwill Ambassador
I have been speaking out on behalf of people living with HIV before we even knew exactly what AIDS was, and I have always had a special concern for children affected by the epidemic. I hope to see a world where every child is born HIV-negative and no child dies from an HIV-related cause.
Recently I have come to realize that we are neglecting a major issue and one that really impacts kids. That issue is tuberculosis – TB for short. It’s the leading cause of death among people living with HIV, even though it’s preventable and curable! To me, this is an outrage and what is more devastating is the impact TB has on children in communities affected by HIV. People living with HIV are much more likely to develop TB than people free of HIV infection.
Without treatment, the vast majority of people with HIV who are sick with TB – including kids – will die within a few months. Add to that another scary fact; infants and young children are at special risk of having severe, often fatal forms of TB, such as TB meningitis, which can leave them blind, deaf, paralyzed or mentally disabled.
The truth? TB has been neglected in children, even though it causes suffering and death all over the world. All told, at least half a million children become ill with TB each year and there are probably more than this because TB often goes undetected and unreported in children. And today we have high hopes for zero transmission of HIV from mother to child. We won’t get there without addressing TB. Why is that? Because TB during pregnancy doubles the risk of transmission of HIV from mother to child. Also, I have heard a lot about the tragedy of AIDS orphans – but not enough about TB orphans. In 2009 there were some 10 million children in the world who had been orphaned by the death of a parent because of TB. TB is most typically a “family” problem. The vast majority of kids who become ill with TB catch it from a close family member before their TB has been diagnosed or treatment has begun. When you realize that, it’s easy to see that you can’t protect children against TB without addressing it within the family and wider community.
What we need to do now is scale up methods that are already available. In countries heavily affected by HIV and TB, everyone should be offered testing for both diseases. That is not happening in most places now. Any person living with HIV who is diagnosed with TB needs prompt, life-saving TB treatment. If they don't have TB, they should get life-saving preventive treatment with the drug isoniazid, so they won't get TB. Needless to say ART should be started early – which also helps prevent TB.
We also need programmes focused on maternal and child health to start paying attention to the risk of TB. What better place to start the integration of TB and HIV care for women and children than at the same clinics where they receive family planning services, prenatal care, immunizations and other services?
By following these simple steps, millions of lives could be saved. But we could achieve even more with simpler diagnostic tests, more child-friendly drugs and a new vaccine. Research into these tools must be increased fast.
The theme of AIDS 2012 is Turning the Tide Together. I truly hope everyone attending the conference—or reading this blog post – will recognize that to end AIDS we must join together to tackle TB and HIV as one disease. We must act now – for the sake of children and their families everywhere.