Joint
news release WHO/UNAIDS
Combining
TB treatment with HIV testing and treatment could save lives of up to 500 000
HIV-positive Africans every year
Joint
call for action follows Mandela's plea at Bangkok International AIDS Conference
to strengthen fight against tuberculosis
21
SEPTEMBER 2004 | ADDIS ABABA, ETHIOPIA -- Expanding access to tuberculosis
treatment, combined with introducing HIV testing and anti-retroviral (ARV) delivery
into TB programmes, could save the lives of as many as 500 000 Africans living
with HIV every year and is one of the most cost-effective ways to ensure the survival
of HIV-positive people, according to international health experts meeting this
week in Addis Ababa, Ethiopia.
Joint
TB and HIV interventions are among the best ways to accelerate access to ARVs
and to help reach the “3 by 5” target of three million people on HIV treatment
by the end of 2005, according to WHO and UNAIDS. “If we jointly tackle TB and
HIV, we can be much more effective in controlling both diseases,” said Dr Peter
Piot, UNAIDS Executive Director.
Of
the estimated 25 million Africans now living with HIV, about eight million also
harbour the bacillus that causes TB. Each year, 5-10% of these eight million co-infected
people develop active TB and up to half, or four million, will develop the disease
at some point in their lives.
Without
TB treatment, HIV infected people with TB typically die within months. Yet national
TB programmes in Africa are currently treating fewer than half of HIV-positive
people with active TB - despite the fact that they respond just as well to TB
treatment as HIV-negative people, and the cost of TB drugs is as low as US$ 10
per patient. But few TB patients are currently offered an HIV test, and only a
handful receive ARVs. Providing ARVs to HIV infected TB patients is now a WHO
'standard of care' policy.
“As
we scale up efforts to increase access to ARVs in Africa we must simultaneously
help people living with HIV survive their bouts episodes with tuberculosis,” said
Jack Chow, Assistant Director-General of the World Health Organization. “This
is one of the most effective ways we can help save lives in Africa.
”The
lack of attention to the risk TB poses for people living with HIV was highlighted
by Nelson Mandela at the recent XV International AIDS Conference in Bangkok in
July. "TB is too often a death sentence for people with AIDS," Mandela said. "Today
we are calling on the world to recognize that we can't fight AIDS unless we do
much more to fight TB as well."
At
the Addis Ababa meeting, the TB/HIV Working Group of the global Stop TB Partnership
- comprising experts from WHO, UNAIDS, the Centers for Disease Control and Prevention,
USAID and other international bodies, as well as Zackie Achmat and other leading
African AIDS activists - called for rapid uptake by African governments of collaborative
interventions to tackle the two diseases simultaneously.
In
addition to strengthening DOTS* programmes in Africa to diagnose and treat TB,
these interventions include regularly offering counselling and testing for HIV
into TB control programmes; screening for TB in HIV/AIDS programmes; and providing
preventive therapy for co-infected people to prevent the development of TB disease.
Managers of several DOTS programmes in Africa have already committed themselves
to support the delivery of ARVs to TB patients who are HIV-positive.
The
Working Group also pledged to provide technical assistance to any country wishing
to submit a TB/HIV proposal for the next round of the Global Fund Against AIDS,
Tuberculosis and Malaria (GFATM).
“We
cannot talk seriously about fighting AIDS while ignoring TB,” said Richard Feachem,
Executive Director of the Global Fund to Fight AIDS, TB and Malaria. “In Africa,
TB and HIV collaborate to kill." Feachem said the Global Fund will modify its
proposal guidelines to request that AIDS proposals also include a strategy to
address TB, and likewise TB proposals also include HIV/AIDS.
In
some regions of Africa, 75% of TB patients are infected by HIV. Yet in Ethiopia,
Kenya, Mozambique, Uganda and Zimbabwe, fewer than 40% of people living with both
TB and HIV are receiving proper TB treatment. In Nigeria, less than 10% of these
cases are receiving proper TB treatment.
*DOTS is the international recommended
strategy for controlling TB that is now implemented in 180 countries world wide.
It has five components: political commitment; microscopy services; drug supplies;
surveillance and monitoring systems; and the use of highly efficacious treatment
regimes with direct observation of treatment.
For
more information contact:
Araya Demissie
Addis
Ababa
Mobile phone: +251 9 250830
Patrick
Bertrand
Paris/Brussels
Mobile phone: +33 6600 40442
Michael
Luhan
Stop TB Partnership
Telephone: +91 (98) 1899 8485
Mobile phone:
+41 (79) 509 0643
Email: lunham@who.int