Presumptive TB treatment for people living with HIV: better safe than sorry?

Babs Verblackt, CNS Special Correspondent
Photo credit: Babs Verblackt/CNS
As tuberculosis (TB) remains a major cause of death among people living with HIV (PLHIV), starting TB treatment without bacteriological confirmation is widely practiced in them as in the case of PLHIV traditional TB diagnostic tests have inadequate sensitivity. But this empirical or presumptive TB treatment is not without risks. At the 45th Union World Conference on Lung Health in Barcelona researchers discussed their investigations into who should get the treatment, and when and how.

Give child pneumonia the attention it deserves

Diana E Wangari, CNS Special Correspondent
When most people are asked about lung health and infectious diseases, the first condition that probably comes to mind is TB. This is expected as, for decades, TB was regarded as a major killer and it showed no discrimination in choosing its victims, infecting children, women and men; rich and poor alike. Neither was it restrictive in its area of destruction—it could attack different organs--from the lungs to the bones. The fight against TB had to be mounted and the campaigns had to be aggressive to match the evolution of a disease that is seemingly outsmarting all efforts to control by appearing in newer avatars of drug resistant TB.

Preparing frontline health workers for community-led change

Nenet L Ortega, CNS Special Correspondent
Photo credit: Nenet L Ortega/CNS
If care for people affected by TB is going to be truly patient-centred, TB services will have to be demand driven and communities will need to be actively involved in the planning and implementation of care. A genuine patient centred TB service rests upon the readiness of its providers, the facility, the TB patients themselves and the whole community. Ideally, services in a TB facility should be rendered by trained health practitioners like the doctors, nurses and other allied health workers.

Tuberculosis does not recognize borders

Shobha Shukla, Citizen News Service - CNS
It is time indeed high time to recognize that globally we have today a 1 billion mobile population, (232 million international and 740 million internal migrants) comprising workers, refugees, asylum seekers, and those forced by climate change to move to other regions. The migration process is fraught with risk factors for TB exposure, infection, transmission and poor outcomes due to social determinants of poverty, substance abuse, and migrant unfriendly health services in receiving countries, making migrants a key affected population for TB.

Alarm rings to contain drug-resistant TB

Shobha Shukla, Citizen News Service - CNS
Retrograde policies and practices and critical gaps in care for multidrug-resistant tuberculosis (MDR-TB) are fuelling a worldwide public health crisis, according to a new report, ‘Out of Step’, released today by Médecins Sans Frontières (MSF) at the 45th Union World Conference on Lung Health at Barcelona.

Embarrassment of riches in HIV prevention response?

Dr Mitchell Warren, AVAC
"There are risks and costs to action. But they are far less than the long-range risks of comfortable inaction" - insightful words of former US President JF Kennedy come in mind while listening to respected HIV prevention research advocate, Dr Mitchell Warren, who is the Executive Director of AVAC - Global Advocacy for HIV Prevention. Considerable improvements have happened in HIV responses but a lot remains undone. With research taking place in HIV science, lot of credible evidence is stacking up on not just basic sciences, but also socio-behavioural and operational aspects of rolling out what we know works. Despite loads of evidence, some policies and practices are not evidence-based and impede HIV responses on the ground.

TB-Diabetes: "An issue relevant all over"

Babs Verblackt, CNS Special Correspondent
The international action against the looming co-epidemic of diabetes and TB should speed up, avoiding a slow response like the one that had happened to the other co-epidemic of TB and HIV years ago. Dr. Anil Kapur, member of the Board of Directors  of the World Diabetes Foundation, explains why - and elaborates on the double burden of diabetes and TB in an exclusive interview with Citizen News Service (CNS).

Meaningful community participation to end TB

Nenet L Ortega, CNS Special Correspondent
Photo credit: Nenet Ortega/CNS
The theme for this year’s  45th Union World Conference on Lung Health, taking place in Barcelona, Spain, is focused on community driven solutions to address health challenges of the next generation. According to Jose Luis Castro, the Executive Director of the International Union Against Tuberculosis and Lung Disease (The Union), the conference  calls on everyone to  explore  the need of generating  health solutions that would address  health challenges  involving the different  stakeholders, policy makers and, most especially, the  people in the communities being served.

Regular HIV prevention counselling reduces risk of infection

Dr Wipas Wimonsate at HIVR4P
"Foundation of HIV prevention is infact HIV testing" said Dr Anthony Fauci of National Institutes of Health at the opening plenary (via video link) of the HIV Research for Prevention (HIVR4P). But mobilizing people to go for voluntary and repeated counselling and testing for HIV has indeed been a challenge. It is even a steeper challenge to mobilize key populations such as men who have sex with men (MSM) to go for HIV testing repeatedly.

Call to action to halt the looming TB-diabetes co-epidemic

Babs Verblackt, CNS Special Correspondent
Dr Anthony Harries, The Union (L),
Dr Anil Kapur, WDF (R)
It is time to act and no time to waste. That is the urgent message of the report "The Looming Co-epidemic of TB-Diabetes: A Call to Action" launched jointly by the International Union Against Tuberculosis and Lung Disease (The Union) and the World Diabetes Foundation (WDF) at the opening day of the 45th Union World Conference on Lung Health in Barcelona. The report warns against the brewing storm of diabetes and tuberculosis (TB) that is no longer confined to the teacup.

Bold and audacious steps needed for TB control

Diana E Wangari, CNS Special Correspondent
Photo credit: Diana Wangari/CNS
When the Indian Minister of Health and Family Welfare Dr. Harsh Vardhan made a speech at the WHO Global Tuberculosis Symposium held just prior to  the 45th Union World Conference on Lung Health in Barcelona, he was greeted with a roaring applause. I could not help but wonder whether it was in recognition for the inspirational speech just delivered or it was an appreciative gesture for a step long overdue.

WHO launches new guidelines on management of latent TB infection

Shobha Shukla, Citizen News Service - CNS
For the first time, the World Health Organization (WHO) has issued guidelines on testing, treating and managing latent TB infection (LTBI) in individuals with high risk of developing the disease. These guidelines were launched today at the Global TB Symposium just before the start of the 45th Union World Conference on Lung Health in Barcelona.

No single HIV prevention method can end AIDS: Combination prevention is key

As HIV prevention needs and contexts vary, it is important to expand the range of effective prevention options that people can use. Archbishop Desmond Tutu said in a video link at the first-ever international conference on all HIV-related biomedical prevention research, that “No single method of prevention can end this epidemic on its own." That is why conferences on microbicides and vaccines merged to provide one single global platform to deliberate on a spectrum of biomedical prevention research for HIV. HIV Research for Prevention (HIVR4P) is being held in Cape Town, South Africa.

Nepal gearing to protect public health from tobacco industry interference

There is a direct and irreconcilable conflict of interest between tobacco industry and public health policy. This conflict of interest is also enshrined in the preamble of the Article 5.3 of the global tobacco treaty (formally called WHO Framework Convention on Tobacco Control). The WHO Director-General Dr Margaret Chan had said at a recent meeting in Moscow: "Giving any tobacco company a place at the negotiation table [of global tobacco treaty] is akin to appointing a committee of foxes to take care of your chickens."