Children, tuberculosis and socio-economic development

RESULTS Sydney City group member, Tima Sannah Brewah, reflects on the barriers to adequate prevention and treatment for TB and HIV, particularly for children. 

Image courtesy ACTION. From the report Childhood TB: From neglect to Action

Developing countries are defined by their varying poverty levels and low socio-economic development. Most lack efficient and effective health systems to ensure much needed health services are available to their population. Tuberculosis is one such disease that places enormous constraints on health systems. Children account for approximately 11% of the global burden of TB according to 2010 estimates however because of the increasing number of under-diagnosed cases, this figure may be higher. More worrisome is TB co-infection in HIV-infected children. Most countries are presently striving to increase BCG vaccination coverage, but the BCG vaccine does not protect children and adults from the most common form of TB. Additionally, maintenance of an efficient cold chain mechanism is often challenging, especially in hard to reach areas as such the effectiveness of the vaccine at the time of administration may be low. Underlying socio-economic issues such as poverty, food security, overcrowding, poor road infrastructure, illiteracy further increases the risk of acquiring TB infections and delays care- seeking and response to therapy. DOTS has proven successful in improving patient compliance to TB drug therapy, however for children the unavailability of fixed-dose combinations of anti-TB drugs results in inaccurate dosage regimens for children, poor compliance to therapy and high administrative costs. In addition, most developing countries lack adequate number of skilled health professionals and health infrastructure to cater for the needs of children infected with TB. Laboratories services are often slow; with inefficient health information systems and cases may often be missed or misdiagnosed. 

The Global Fund to Fight AIDS, TB and Malaria has provided a platform for the integration of TB and HIV programming for the most-at –risk children. However, despite the high burden of these diseases and their inter-relatedness, in most developing countries, TB prevention, treatment and diagnostic services are not part of current child health services and there is poor coordination among the National Programmes for Malaria, TB and HIV.  

In order to ensure aid effectiveness, key international aid donors need to prioritize the funding of research and development of new TB vaccines, diagnostics and treatment that are more effective for children, and those people living with HIV. A comprehensive assessment of current national, regional and global maternal and child survival policies is required to ensure well-coordinated TB response mechanisms for children. If countries are to make progress socio-economically and otherwise, the next generation of leaders, policy makers and workers, need to be much better protected from these diseases of poverty. 

 Our guest blogger Tima Sannah Brewah

Every disabled and able child has the right to go to school

Image credit: CBM (Courtesy of UNICEF Australia)

LIVING with a disability in the developed world can be a struggle. Living with a disability in poverty can be an unimaginable struggle.

International Day of People with Disability was on Monday, December 3.

The day aims to promote an understanding of people with disability and encourage support for their dignity, rights and well-being.

Disability is a growing issue in our region and extreme poverty can cause disability through poor nutrition, inadequate working conditions and a lack of access to clean water, sanitation and health care.

According to AusAID, children with disability are less likely than their peers to start and to complete school.

In fact, in low income countries only 46 per cent of males with disability and 33 per cent of females with disability have completed primary school, compared with 56 per cent of males and 42 per cent of females without disabilities respectively.

“A child who has to struggle with a disability and poverty should be totally unacceptable and non-existent in today’s world,” Ms Maree Nutt, National Manager of RESULTS, said.

RESULTS’ Education for All Report released earlier this year recommends mainstreaming disability into education by adapting buildings and classrooms appropriately so that students can attend and that teachers and support staff are adequately trained in adaptive curricular and resources, i.e. braille.

“There needs to be better monitoring of disability plans in developing countries education programs,” Ms Nutt continued. 

As a leading donor on education, Australia should use its influence at the World Bank and the Asian Development Bank to push for greater measures so that disabled children can go to school.

“Every child, disabled and able, has the right to go to school,” Ms Nutt affirmed.

World AIDS Day 2012

Saturday was International World AIDS Day (WAD). Observed worldwide on the 1^st of December every year since 1988, WAD raises awareness of the pandemic of AIDS caused by the spread of HIV, through the organisation of events around the globe, speeches by country leaders and major fundraising efforts, such as the famous red ribbon collection. Each year has a theme, and since 2011 and until 2015, the theme will remain Getting to Zero, representing a powerful push towards the eradication of HIV/AIDS in the lead-up to the end of the Millennium Development Goal era.

In Australia this year, WAD is in part being marked by the opening of the Access to Life exhibition at the Powerhouse museum in Ultimo, to coincide with the 30 years since the first case of HIV was diagnosed in Sydney. The exhibition, which has toured Rome, Madrid, Oslo, New York, Oakland, Tokyo and Seoul since opening in 2008, is a collection of case study photographs of people affected by HIV/AIDS taken by some of the world’s leading photographers from the Magnum photographic agency, and has been organised in partnership between the Global Fund to Fight AIDS, Tuberculosis and Malaria and Magnum Photos. The Global Fund is a public/private partnership and international financing institution that supports large-scale prevention and treatment against the three major diseases of poverty. In the Asia Pacific region alone, half a million people have received life-saving HIV/AIDS treatment due to the Global Fund. 

Members of RESULTS Australia, along with a number of key people involved in the fight against HIV/AIDS, attended the opening of the exhibition in Sydney this week. The evening included speeches by the chair of the Global Fund, Simon Bland and the Governor General of Australia and patron of the Global Fund, Quentin Bryce. There were also two joint musical performances by Australian and Papua New Guinean artists. Local David Bridie performed with PNG singer George Mamua Telek, and members of the Australian band the Jezebels performed with the PNG-born singer Ngaiire. Ngaiire’s powerful performance was heightened by her positioning on a raised, red velvet-draped podium in the centre of the Powerhouse museum, backed by a rotating show of moving photographs projected onto the wall behind her. The images were taken from the series of photographs from Papua New Guinea, a new part of the exhibition unveiled for the first time in Sydney on this opening night. 

Click on the links below to find out more about the exhibition.

Exhibition

Video

World Aids Day