Overview
The Union has published Silent Epidemic as a call to action against child TB. The following pages lead you through the key aspects of our report, which can also be downloaded in full and which we encourage you to share widely.
The right to equal access to healthcare is enshrined in international human rights agreements, including the Convention on the Rights of the Child, the European Convention on Human Rights, the American Convention on Human Rights, and the African Charter on Human and Peoples’ Rights. Yet children are being made to suffer from an epidemic of TB—an airborne, communicable disease that is often fatal without treatment.
Child TB is a silent epidemic—one that impacts children mostly too young to advocate for themselves. The best available data show an estimated one million children under the age of 15 become sick with TB each year. Of those, 239,000—nearly one in four—die. Children with TB rarely die when they receive standard treatment for the disease, but 90 percent of children sick with TB worldwide are left untreated. This widespread neglect means the loss of a million children every four years, creating trauma for the families they leave behind—households where an adult is likely to have had TB.
Children with TB rarely die when they receive standard treatment for the disease, but 90 percent of children sick with TB worldwide are left untreated.
This massive toll of deaths among children results from systematic disregard for children’s rights to health. Within global public health, it is an open secret that health systems neglect children with TB because children are less contagious than adults (stopping the spread of TB is a priority), and because the standard tools used to diagnose TB work less well in children.
This neglect can no longer be excused on grounds of economy or expediency. TB is preventable, treatable, curable. Multiple international agreements state that equal access to medical care is a basic human right, along with the right to enjoy the highest level of personal health possible. These treaties are considered legally binding on all signatory nations. The continuing medical neglect of child TB, resulting in millions of avoidable deaths, constitutes a human rights violation by any reasonable measure.
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. Precedents from national courts and international tribunals, including the Committee on the Rights of the Child, the European Court of Human Rights (ECHR), and the African Court on Human and Peoples’ Rights (ACHPR) have compelled governments to ensure the delivery of TB treatment. These cases show that in some circumstances, systems of justice can compel governments to provide TB care to children.
“The continuing medical neglect of child TB, resulting in millions of avoidable deaths, constitutes a human rights violation.”
Ending the child TB epidemic requires local interventions, sensitive to social and cultural context, to reach at-risk children using simple tools for active screening and diagnosis. Even in resource-limited areas, projects like DETECT Child TB are demonstrating that medical professionals can be equipped with the knowledge and tools to diagnose and treat TB in children, with access to care provided at the community level. Screening households where an adult is diagnosed with TB to see if children have been exposed in the home must become the standard implemented everywhere. Where The Union has piloted this approach in Uganda, 72 percent of at-risk children were able to receive preventive TB treatment, up from less than five percent previously.
In the long run, greater investment in research and development needs to deliver better diagnostics, treatments and an effective vaccine that prevents TB. To be a success, the UN High-Level Meeting on TB in September 2018 needs to generate concrete action, where governments are held accountable for achieving time-bound targets, for investing in new research and delivering the care to which all children with TB have a fundamental right.
