HIV/AIDS, TB Programs Must Cooperate To Save Lives

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A lack of cooperation between tuberculosis and HIV/AIDS programs iscausing 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 Onlinereports. According to Reid, all people living with TB should be offeredHIV tests, as well as access to antiretroviral drugs. In addition, allHIV-positive people regularly should be screened for TB and providedwith access to the preventive drug isoniazid, Reid said. "Theselifesaving activities can be achieved with greater cooperation betweenTB and HIV programs," Reid said, adding, "They are cheap, simple andreadily 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 preventscollaboration. "HIV has always been the big kid on the block, with TBbeing the little brother," she said, adding, "HIV programs andorganizations seem to be afraid that TB takes away attention andfunding" (Mannak, Inter Press Service, 11/11).

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Upto half of reported HIV/AIDS-related deaths are caused by TB, accordingto Reid. He added that in 2005, about 7% of people with TB worldwidewere tested for HIV and that fewer than one in 200 people living withHIV/AIDS were tested for TB. "Globally, we are missing vitalopportunities to offer better care and prevent unnecessary deaths amongpeople living with HIV and among TB patients," Reid said. According toReid, testing people who have TB for HIV and vice versa could lead toearlier detection, increased access to antiretrovirals and theprevention 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.

Toaddress the issue, the TB and lung disease union has proposed a program-- called "Integrated Care for TB Patients Living with HIV/AIDS" -- tosimultaneously address both diseases. Central components of thestrategy include increased collaboration in addressing TB and HIV, andtesting for the two diseases. The strategy is being tested in variouscountries, including the Democratic Republic of Congo, Uganda andZimbabwe.

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

Earlydata from worldwide monitoring of joint TB/HIV activities haveindicated some progress compared with previous years, according to the SAPA/Independent Online.Since 2005, there has been a threefold increase in the number ofHIV-positive people who have been screened for TB and a sixfoldincrease 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).

Reprinted with permission from kaisernetwork.org. You can view theentire Kaiser DailyHIV/AIDS Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily HIV/AIDS Report ispublished for kaisernetwork.org, a free service of The Henry J. Kaiser FamilyFoundation.

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