HIV/AIDS, TB Programs Must Cooperate To Save Lives, Health Officials Say

A lack of cooperation between tuberculosis and HIV/AIDS programs is causing deaths from the two diseases in many countries, Alasdair Reid, HIV/TB adviser for UNAIDS, said on Friday at the 38th Union World Conference on Lung Health in Cape Town, South Africa, the SAPA/Independent Online reports. According to Reid, all people living with TB should be offered HIV tests, as well as access to antiretroviral drugs. In addition, all HIV-positive people regularly should be screened for TB and provided with access to the preventive drug isoniazid, Reid said. "These lifesaving activities can be achieved with greater cooperation between TB and HIV programs," Reid said, adding, "They are cheap, simple and readily available in most countries" (SAPA/Independent Online, 11/9).

Paula Fujiwara -- senior technical adviser and director of the HIV/AIDS department at the International Union Against Tuberculosis and Lung Disease -- at the conference said, "So far, many TB and HIV programs in Africa -- or anywhere in the world -- do not cooperate with one another, despite the strong connection that exists between HIV and TB." According to Fujiwara, competition is a major factor that prevents collaboration. "HIV has always been the big kid on the block, with TB being the little brother," she said, adding, "HIV programs and organizations seem to be afraid that TB takes away attention and funding" (Mannak, Inter Press Service, 11/11).

Up to half of reported HIV/AIDS-related deaths are caused by TB, according to Reid. He added that in 2005, about 7% of people with TB worldwide were tested for HIV and that fewer than one in 200 people living with HIV/AIDS were tested for TB. "Globally, we are missing vital opportunities to offer better care and prevent unnecessary deaths among people living with HIV and among TB patients," Reid said. According to Reid, testing people who have TB for HIV and vice versa could lead to earlier detection, increased access to antiretrovirals and the prevention of "thousands of deaths" (AFP/Google.com, 11/9). Fujiwara said that in some African countries, 75% to 80% of people who have TB also are living with HIV/AIDS. World Health Organization data indicate that 90% of HIV-positive people in Africa die within months of contracting TB.

To address the issue, the TB and lung disease union has proposed a program -- called "Integrated Care for TB Patients Living with HIV/AIDS" -- to simultaneously address both diseases. Central components of the strategy include increased collaboration in addressing TB and HIV, and testing for the two diseases. The strategy is being tested in various countries, including the Democratic Republic of Congo, Uganda and Zimbabwe.

According to Reid, a new funding model should be developed to address the two diseases. "Currently, money is raised for either HIV or TB, and funds dedicated for HIV can't be used for TB or vice versa," he said, adding, "This has to change. When you want to tackle HIV you need to tackle TB, especially in Africa where so many people are co-infected" (Inter Press Service, 11/11).

Early data from worldwide monitoring of joint TB/HIV activities have indicated some progress compared with previous years, according to the SAPA/Independent Online. Since 2005, there has been a threefold increase in the number of HIV-positive people who have been screened for TB and a sixfold increase in the number of people with TB who were tested for HIV. However, Reid said that without immediate action, "it will be very, very difficult" to achieve the HIV/AIDS targets in the U.N. Millennium Development Goals and that "thousands of people with HIV will continue to die of preventable, treatable" TB (SAPA/Independent Online, 11/9).

Kaisernetwork.org is serving as the official webcaster of the conference. Webcasts of select sessions, interviews and other resources are available online.

Additional coverage of news and developments from the conference is available at GlobalHealthReporting.org.