CNS: Articles of Chief K Masimba Biriwasha

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Ending TB in Children Requires USD 120 Million Annually

Chief K Masimba Biriwasha - CNS
According to an ambitious plan launched today by leaders in the TB field, a total of USD 120 million is require to stem the TB among children (including those co-infected with TB and HIV). The Roadmap for Childhood TB: Toward Zero Death, outlines three priority areas that require attention in order to turn the tide in the fight again TB including: a sense of urgency beyond the TB community, improvement in research, policy development and clinical practices as well as increased funding.

With diabetes largely associated with over-consumption of sugar by many Zimbabweans, it is hardly surprising that its link to tuberculosis (TB) is hardly a public health matter. TB kills more than 3,500 people each day worldwide, leading to approximately 1.4 million deaths every year. One-third of the world's population is currently infected with the causative agent of TB, and 8.8 million new cases of active TB are estimated to occur around the world each year.

LOVING memories of my grandmother’s cooking hut in the backyard of Zimbabwe are still fresh inside me like morning dawn. Yet, I also remember how the hut would fill up with smoke that choked my throat and stung my eyes and how I sat through it all enjoying a meal or engaged in conversation with loved ones. Little did I know that it was a health hazard. Like most Zimbabweans – approximately 70 per cent of the population lives in rural areas – it was a normal facet of our lives. In fact, if one revealed any lack of resilience against the smoke, they would be regarded as a snobbish urbanite. And not many people are willing to be associated with such a tag.

Quicker Response Required to Fight MDR TB

Harare, Zimbabwe – Zimbabwe, like many countries across the world, is set to benefit from ongoing research into cheaper, quicker clinical responses to MDR-TB. Each year, 440,000 MDR-TB cases emerge and 150,000 people die. To prevent these unnecessary deaths, the International Union Against Tuberculosis and Lung Disease (the Union) programme, TREAT TB Initiative, is sponsoring a multi-country clinical trial – STREAM – which will evaluate a markedly shorter and more tolerable treatment regimen for MDR-TB.

Condom-compatible lubes are a rarity in Africa forcing transgender women, gay men and other men who have sex with men (MSM) and heterosexual populations that engage in anal sex to utilize alternative methods that potentially exposes them to a range of sexually transmitted infections including HIV, the virus which causes AIDS. Following a meeting of Africa for Rectal Microbicides (Project ARM) held in Addis Ababa, Ethiopia, in December 2011, participants decided to create the Global Lube Access Mobilization (GLAM) initiative to support increased access and availability of condom-compatible lubes throughout the world, beginning with a focus on Africa, employing the tagline "And Lube!"

UGANDAN AIDS activist and medical doctor, Paul Semugoma, 42, said that rectal microbicides have a potential to save the unnecessary loss of lives among men who have sex with men in Uganda and across Africa. According to a study titled, "HIV Infection among Men Who Have Sex with Men in Kampala, Uganda – A Respondent Driven Sampling Survey," it is estimated that the adult male HIV prevalence in Kampala is 4.5 per cent but the prevalence estimates among men who have sex with men (MSM) is 13.7 per cent. Most MSM still have sex with women, many are married, co-habit with women, and have biological children. MSM in Kampala appear firmly embedded in the general population.

Unprotected anal sex has long been regarded as a key driver of HIV transmission in many parts of the world, especially among men who have sex with men. In many contexts, the practice is surrounded with stigma and discrimination which is a key barrier to developing protective measures, and largely pushes affected populations to go underground far from the reach of public health services as well as HIV prevention tools.

Microbicide research has gained momentum in recent years with focus largely on products to prevent HIV during vaginal sex. However, there is a growing momentum to develop rectal microbicides for women, men, and transgender individuals around the world who engage in anal intercourse. Microbicides are products (currently under research) designed to prevent or reduce the sexual transmission of HIV or other sexually transmitted infections when applied inside the vagina or rectum. Most vaginal microbicides are being tested as gels or rings, while rectal microbicides are primarily being tested as gels.

Gender Based Violence Drives HIV Epidemic Among Women: US Study

One out of every four people living with HIV in the US is a woman according to a new study by the University of California, San Fransisco (UCSF). Further, it is estimated that 30 percent of women living with HIV in the country experience post traumatic stress disorder compared to 5,2 per cent in the general population.

Lack of Resources Hinder Zim’s TB/HIV Response

While the problem of TB/HIV co-infection has long been recognized in Zimbabwe, limited resources, poverty and brain drain among others continue to hamper efforts to address the matter. Zimbabwe’s Ministry of Health and Child Welfare even has an AIDS and TB Unit aimed at coordinating the national response to the two epidemics. In the past few years, however, TB has emerged as a leading killer, especially among HIV positive people, who are often not identified though long-established TB tests. Statistics shows that the success rate of directly observed treatment is just 74 percent, far below the WHO recommended rate of 85 percent.

Zimbabwe Battles HIV and TB Epidemics

Harare, Zimbabwe – Charles Raradza, 44, fell seriously ill in 2001, coughing uncontrollably. He went to get tested for tuberculosis (TB) at a hospital in Kadoma, Zimbabwe but the bacteria that causes the disease was not detected in his sputum. Determined to get to the bottom of his illness, Raradza went to another hospital where a sputum and lung X-ray test revealed that he was indeed TB-infected. “I was immediately enrolled into the hospital’s directly observed treatment therapy (DOTS), and had to take 13 tablets a day. The tablets were very painful. I guess because I love life so much I never defaulted during the six months that I was on the course,” said Raradza. But after two years, Raradza started coughing uncontrollably again. He went to get tested for TB again. “At the hospital, it was discovered that I had TB for the second time, so I was given 60 injections and tablets – it was painful but I stuck through it. I was put on the 6-month long DOTS programme again,” he said.

Integrating TB/HIV Services in Zimbabwe: A Key Public Health Priority

Harare, ZIMBABWE - In Zimbabwe, there is a wide recognition of the need to integrate TB and HIV services but for people living with HIV (PLHIV), it is not evident, said Martha Tholanah, Coordinator of the International Community of Women Living with HIV (ICW) Zimbabwe Chapter. While Zimbabwe has made progress in implementing collaborative TB/HIV activities, much work still remains to be done to make them an integral part of the health service. Tholanah said that civil society in had also failed to spearhead the integration of TB and HIV in the country. “There is too much fragmentation. National AIDS Council (NAC) needs to strengthen coordination. I think we (CS) have always made much noise about demanding NAC to be accountable, but I do not think we have been accountable ourselves,” said Tholanah.

Harare, Zimbabwe – Tuberculosis (TB) is a major public health problem in Zimbabwe yet very little is known about the impact of the disease on children. Without a functional healthcare system and research into paediatric TB, Zimbabwe is likely to continue losing its children to this hidden public health problem. Among African nations, Zimbabwe is one of those most heavily affected by TB. The Global Tuberculosis Control Report from the World Health Organisation (WHO) ranks Zimbabwe 17th among 22 countries worldwide with the highest TB burden.

In 2005, Tariro Jack, 27, fell ill with Tuberculosis (TB) during her first year at college. She said that she struggled to cope not only with her own health but also managing people's perceptions. TB is an infectious disease that spreads through the air. The disease mostly affects young adults in their most productive years and 95% of TB deaths are in the developing world. Estimated TB incidence rates are highest in sub-Saharan Africa with over 350 cases per 100,000 population. Among African nations, Zimbabwe is one of those most heavily affected by TB. The deadly combination of TB and HIV epidemics is igniting a silent and uncontrollable epidemic of drug resistant TB that will negate previous national health gains.

Tuberculosis (TB) among children is rarely discussed. Because children, more often than not cannot speak for themselves, not much about how they're affected by the disease ever hits the headlines. This is despite the fact that TB remains among the top ten killers of children worldwide. In spite of this, virtually no public or political attention is paid to TB as a children’s health issue. The World Health Organization (WHO) estimates that approximately 176,000 children died, but the consensus among researchers says that actual figures are higher. In 2009 alone, at least 1 million children became sick with TB.

Today is March 8, and across the world the International Women's Day is being commemorated. Coincidentally, March is the global tuberculosis (TB) awareness month. The disease, which is caused by a mycobacterium, has a major impact on women's sexual reproductive health and that of their children. For pregnant women living in areas with high TB infection rates, there are increased chances of transmission of TB to a child before, during delivery or after birth. The disease, especially if associated with HIV, also accounts for a high incidence of maternal and infant mortality. Unfortunately, there is little to no attention to women's vulnerability in the current discussion and media blitz of a resurgent TB internationally, and in particular, sub-Saharan Africa.

GROWING up in Zimbabwe, diabetes (a polygenic disease characterized by abnormally high glucose levels in the blood) was something that the old people always talked about, and the fear of the disease grew over me like a giant baobab. To describe a person with diabetes, the old people would say in local parlance "Ane shuga", which literally means: "He/she has sugar". Essentially, it meant that the affected person has a disease associated with sugar. To my childhood fancy, I thought that the people who were affected with the diabetes ate a lot of sugar only to discover later it was the common understanding.

TUBERCULOSIS (TB) has a major impact on women's sexual reproductive health and that of their children. For pregnant women living in areas with high TB infection rates, there are increased chances of transmission of TB to a child before, during delivery or after birth. The disease, especially if associated with HIV, also accounts for a high incidence of maternal and infant mortality. Unfortunately, there is little to no attention to women's vulnerability in the current discussion and media blitz of a resurgent TB internationally, and in particular, sub-Saharan Africa. Read more

AIDS: Where Goes the Money?

JUST how much money are the recipients of AIDS funds putting into

programmes that have a real impact on communities affected by the disease without hip- hopping around the world or engaging in endless AIDS workshops? It appears that unless there is serious public account of where exactly AIDS dollars are going, we are in for a long ride with the epidemic.

In order to make real progress in the response to AIDS, the whole concept of what money means to the response has to be rethought. Because where the money is going in many cases is doing little tochange the course of the epidemic. Except make some people rich and fat and making a glitz out of the disease.

The AIDS community in many parts of Africa is very dispassionate; there is no real anger, and the business of the day consists of filling in donor proposals and donor reports pasted with pictures ofpeople supposedly living with HIV and AIDS. The AIDS response in Africa is so air-conditioned that its ineffective: it lacks vigour for real change. Read more.

While community home based care is the preferred means of providing care for people living with HIV in many parts of Southern Africa, it comes with massive costs especially to caregivers in terms of time, effort and commitment, according to a study published recently in the Journal of the International AIDS Society. Read more