AFRICA: TB failures threaten HIV treatment gains

Photo: Kristy Siegfried/PlusNews

A TB clinic in Lesotho, which has one of the highest rates of TB-HIV co-infection in the world

MEXICO CITY, 8 August 2008 (PlusNews) - Tuberculosis (TB) is the biggest killer of people living with HIV in Africa, but only one percent of HIV-positive people accessing treatment were screened for TB in 2006, an oversight that activists say threatens to roll back the gains made in placing more than three million people on life-prolonging anti-retroviral (ARVs) treatment.

“We are facing a preventable plague in a devastating epidemic,” Michael Sidibe, deputy executive director of UNAIDS, told a press conference calling for urgent action on TB from governments and donors at the International AIDS Conference in Mexico City on Thursday. “ARVs alone are insufficient to protect people from TB.”

According to data from the World Health Organisation, globally, only about 314,400 people were screened for TB in 2006, 26 percent of whom were found to have an active form of the disease. HIV-positive people are 50 times more likely than HIV-negative people to develop TB, and without proper treatment, 90 percent of them usually die within months.

Despite these statistics, none of the three biggest AIDS donors – the Global Fund to Fight AIDS, Malaria and TB, the United States President’s Emergency Plan for AIDS Relief and the World Bank – have incorporated requirements for TB testing to be provided to people living with HIV in their programmes.

Jim Kim, from Harvard University’s Centre for Global Health, noted that the tools for diagnosing TB were outdated and needed development, but added that even with the existing technology, HIV programmes could and should be doing better.

“TB is a very curable disease – even extremely drug resistant (XDR) TB has had good cure rates in some countries, such as Peru,” Kim said. “It is a crime for people with access to ARVs to continue to die from TB.”

Kim said the initial rush to deal with the crisis of HIV had led to HIV services evolving separately from TB services. “But now the focus needs breadth – HIV-positive people need the full range of public health services, including TB care,” he said.

Activists noted the need to create more awareness about the importance of TB screening among people living with HIV and the general public.

Vuyiseka Dubula, secretary general of South Africa’s Treatment Action Campaign, said: “Ignoring TB screening and care undermines all the gains made in HIV treatment.”

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See also: KENYA: Lucy Chesire: "The three big scars in my life are because of TB-HIV co-infection"