Whoopi Goldberg calls for action on childhood TB at International AIDS Conference

27 July 2012 - Washington DC - Today at the closing of a special session at AIDS 2012, the International AIDS conference, award-winning actor and UNICEF Goodwill Ambassador Whoopi Goldberg made an impassioned call for urgent action on TB/HIV among children and women. "We are going to have to come to terms with this and join in making this partnership between TB and HIV dissolve. This is something we have to be dealing with now and not later," she said.

The session, "Looking to the Future in HIV and TB", offered an overview of the latest developments in HIV and TB, including the state-of-the art in TB diagnostics, prevention, and treatment; emerging data on delivery of HIV/TB care: and TB vaccine development.

TB/HIV activist and Executive Director of TAG Mark Harrington led off with his own challenge on children and TB. "For the past fifty years TB programmes have been ignoring children: That has to change," he said. "We need to put together all the tools in our toolkit to prevent and treat TB."

Alison Grant, Professor of International Health at the London School of Hygiene and Tropical Medicine raised hope that novel preventive treatments combining isoniazid and a second drug appear to have greater efficacy. "We already know that people living with HIV who have a positive skin test have two-thirds reduction in risk of getting TB if they receive isoniazid - this figure could be improved," she said.

Recalling an era half a century ago when the US medical community believed TB had been beat" and efforts on research evaporated, Dr Richard Chaisson, Director of the Johns Hopkins Center for Tuberculosis Research, noted that funding has increased dramatically in TB research since the 1990s, but is still "woefully inadequate". To demonstrate his point, Chaisson projected a poster from the 2012 World TB Day campaign calling for zero TB deaths - and suggested the zero concept could be promoted another way. "Let’s add a zero to the funding figure for TB research," he said. In closing he praised recent innovations in TB diagnosis, such as Xpert, and the promise of the new drug combination that was the subject of a major announcement by the Global Alliance for TB Drug Development this week.

Dr Haileyesus Getahun, Coordinator of the TB/HIV and community engagement unit at the WHO Stop TB Department and manager of the Secretariat of the Stop TB Partnership Working Group on TB/HIV, reported that HIV testing for TB patients is increasing dramatically, especially in Africa. But there is a mismatch between availability of TB and HIV services: the delivery of HIV care and antiretroviral therapy (ART) is very centralized; TB care has generally been decentralized.

WHO has clear policies for tackling TB/HIV and saving lives. What is needed now, Getahun said, is to introduce TB services into HIV services and vice versa. And the best option for people living with HIV and affected by TB is "one stop" services. He cited data showing Kenya saw a 15% decrease in mortality when this type of service was introduced and spurred a round of applause when he urged that nurses and clinical officers begin delivering ART, just as they do TB treatment.

Dr Thomas Evans, Chief Scientific Officer at Aeras, noted that we have reason to be hopeful about having a fully effective TB vaccine, because 80% to 90% of people infected by M tuberculosis have natural immunity against active TB disease. Also there are many entry points for a vaccine: We can try to have vaccine that prevents infection, for example, or one that prevents disease post infection. Aeras has a rich pipeline of vaccine candidates and also is looking at promising new biomarkers.

Whoopi Goldberg, who was speaking publicly at TB/HIV event for the first time, commented that she had discovered the urgency of the issue only recently. "For me it is a little shocking to hear folks say we need to raise more money, we need to get more help. I always thought we were so much further ahead than we are. So I am really glad to be here to do what I can," she said.

Goldberg spoke of her commitment to advancing efforts for children affected by TB. "The truth is TB has been neglected in children, especially in communities affected by HIV," she said. And she drew chagrined laughter when she expressed outrage over the number of women who die of TB each year - half a million - and said, "Why do women always get the fuzzy end of the lollipop?" In closing she said: "The theme of this conference is turning tide together. I would like to see that happen. To end AIDS we have to join together to tackle HV and TB as one disease."

Amid wild applause, Dr Diane Havlir, US Co-Chair of AIDS 2012 and Chair of the Stop TB Partnership Working Group on TB/HIV, closed the session.