Living With AIDS, Dying of TB
One in four deaths among people living with HIV/AIDS (PLHA) results from tuberculosis (TB). Despite being the leading infectious killer of PLHA, the percentage of PLHA that are regularly screened for TB has increased from 0.6 percent to only 4.1 percent since 2004.
Health advocates are outraged that patients are not being dually tested for both diseases.
“I have had HIV for almost 20 years, and the only time I’ve ever come close to dying was with TB,” said Lucy Chesire, a renowned TB-HIV advocate from Kenya. “I am not sick from TB anymore, but I am sick, tired and fed up that TB screening is not being provided to 96 percent of HIV-positive people.”
For two decades, the HIV/AIDS community has known that TB and HIV/AIDS are intimately linked, particularly in sub-Saharan Africa where HIV/AIDS has caused TB incidence to triple since 1990. Yet, after years of promises, declarations, and calls to action, HIV programs are still failing to identify the most likely infection to kill those accessing HIV services. According to the WHO 2009 Global Tuberculosis Control report, the most recent data show a total of 1.4 million HIV-positive people attending HIV care services were screened for TB. This is only 4.1 percent of the total 33.3 million estimated PLHA.
“WHO’s policy is that every person with HIV/AIDS should be regularly screened for TB,” said Emily Wainwright, Project Director for ACTION. “So the fact that only 4.1 percent of HIV-positive people around the world are screened for TB is simply rampant, unmitigated malpractice.”
Country-level HIV/AIDS programs are not the only actors failing on this issue. The leading sources of international HIV/AIDS funding - the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank - do not routinely monitor how many PLHA are being screened for TB in HIV/AIDS programs they support.
“None of the three biggest AIDS donors are reporting the proportion of PLHA being screened for TB,” said Wainwright. “It is essential that these donors ramp up HIV testing for TB patients, further operationalize stated commitments to collaborative TB-HIV services, and significantly increase resources for TB-HIV services.”
To stop people living with HIV from dying of TB, HIV/AIDS programs must screen all PLHA accessing HIV/AIDS care for TB and make the “3 Is” - intensified case finding, infection control, and isoniazid preventative therapy - central to HIV/AIDS services and universally available.
Additionally, affected countries, donors, and technical agencies must act to ensure universal access to quality TB-HIV care by the year 2015 - moving in coordination with the goal of universal access to ART. Likewise, heads of state and ministers of health in endemic countries must take the lead by committing to a goal of universal access by 2015 on TB-HIV care.
Dr. Anthony Harries, Senior Advisor to the International Union Against TB and Lung Disease, highlighted an additional challenge in limiting the suffering caused by the dual epidemics. According to Harries, TB-HIV co-infection is likely the leading cause of death of health workers in sub-Saharan Africa.
“All around Africa immuno-compromised patients and health workers are being crowded in the same cramped clinics with people who likely have TB and even drug-resistant TB. Then we refuse to screen them for TB,” said Dr. Harries. “This is wrong, this is deadly, and this must stop immediately.”
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About ACTION
ACTION (Advocacy to Control Tuberculosis Internationally) is an international partnership of civil society advocates working to mobilize resources to treat and prevent the spread of tuberculosis (TB), a global disease that kills one person every 20 seconds.
ACTION’s mission is to build support for increased resources for effective TB control, especially among key policymakers and other opinion leads in both high TB burden countries and donor countries. With effective policy advocacy and greater political will, rapid progress can be made against the global TB epidemic
For more information, contact: Blair Hinderliter,
+1 202 230 2188;/ 0650 310 1638, bhinderliter@results.org
Posted 1 year, 10 months, 2 days, 6 hours, 4 minutes ago
