PHA-Exch> AFRICA: TB failures threaten HIV treatment gains

[Claudio Schuftan]

From: RKoppenleitner RKoppenleitner at t-online.de

1 - AFRICA: TB failures threaten HIV treatment gains

MEXICO CITY, 8 August (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tools for diagnosing TB were outdated and needed development, but added that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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