2016 marks the beginning of the Sustainable Development Goals (SDGs) era.
And the world is making progress in tackling tuberculosis (TB), the leading infectious disease killer along with HIV.
Last weekend, global health professionals, TB specialists, researchers, civil society and communities affected by TB convened for TB2016 in Durban, South Africa.
The indaba was organised by International AIDS Society (IAS).
TB2016 falls immediately prior to Aids2016—the world’s largest conference on any global health or development issue, which started on July 18, 2016.
International Union against TB and Lung Disease press statement titled TB 2016 and Aids 2016: Jointly Tackling the Co-epidemic says the diseases together make up a co-epidemic, posing unique challenges to individuals and communities that bear the burden of both diseases at the same time.
“By convening in tandem with Aids2016, TB2016 demonstrates the benefits of fostering close relationships between the HIV and TB communities—and shows the need for greater attention to the global TB epidemic,” the statement says.
The statement says TB and HIV are deeply intertwined, particularly in sub-Saharan African countries such as Malawi, adding that TB has become the leading cause of death among those who are HIV-positive despite that today HIV infection can be managed with antiretroviral medication, and TB can be cured in the vast majority of cases.
“Since HIV infection weakens the immune system, a person living with HIV is 26 to 31 times more likely to develop active TB than someone who is HIV-negative. Of the 1.2 million people who died from HIV in 2014, one in three deaths resulted from TB-HIV co-infection. At the same time, 25 percent of all TB deaths were HIV-associated. Based on post-mortem autopsies, nearly half of people living with HIV who died from TB had undiagnosed TB at the time of death,” part of the statement reads.
Director for National TB Control Programme, Doctor James Mpunga, admits that TB and HIV co-infection is still a public health concern despite Malawi having made strides in the area.
He says the proportion of HIV-positive TB patients initiated on antiretroviral therapy (ART) has increased from 81 percent in 2012 to 88 percent in 2013 and the proportion of TB/HIV co-infected people has decreased from 77 percent in 2000 to 57 percent in 2013, adding: “The proportion of TB patients that unfortunately die while on treatment is seven percent for smear positive TB cases.”
National TB Control Programme 2014 TB prevalence survey indicates that half of the people who are suffering from TB may still be missing as there are lots of TB patients in the community who are not detected and treated.
Close to 19,000 TB cases were reported in 2013.
“We cannot win the fight against Aids without also tackling TB,” IAS President-elect, Linda-Gail Bekker, says: “Too often, TB and HIV team up against us, but with this conference, we are supporting a global movement to bring the TB and HIV responses together to defeat both epidemics. TB2016 reminds us that the work before us will take place not only in laboratories but also in the halls government, in health facilities and in the communities affected by these two devastating epidemics.”
The Union statement highlights that it is essential that the global health should address the TB-HIV co-epidemic at every opportunity.
“We know what to do; the World Health Organisation (WHO) first endorsed a policy approach for jointly addressing TB-HIV in 2004. Since 2005, WHO estimates that 5.8 million lives have been saved by interventions that have jointly addressed TB and HIV. Yet, in 2014, only half of TB patients worldwide had a documented HIV test result—the first step in initiating treatment and care for TB-HIV co-infection,” the statement says.
WHO says TB continues to pose a significant challenge to the HIV response. The health organisation says in the era of ART scale-up, TB is still the main cause of hospitalisation and deaths among people living with HIV.
It further highlights that bold targets for HIV are included in the Fast Track Strategy to end the Aids epidemic by 2030 and implicit in these targets is the urgent need to address HIV-associated TB.
One of the targets for goal three of the United Nations SDGs states that by 2030, there is need to end the epidemics of Aids, TB, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.
There are 17 SDGs and 169 targets that were launched in September 2015 to seek to build on the initial Millennium Development Goals and complete what they did not achieve.
Meanwhile, the international AIDS Conference is underway in Durban, South Africa
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