World AIDS Day:Experts Call for Scaling of HIV-Tuberculosis Treatment

Joseph Elunya, Uganda 
(First published in The Continent Observer, Uganda on 30th November 2013)
As countries around the world commemorate the World AIDS Day on Sunday 1st December experts are calling for the scaling up of treatment for Tuberclosis and HIV/AIDS. The experts note that with more than one million people needing simultaneous treatment for TB and HIV, it is essential that services for the patients be scaled up and coordinated within the general health system.

According to Dr Anthony Harries, Senior Advisor, International Union Against Tuberculosis and Lung Disease says HIV/AIDS related death can be controlled if services are scaled up for the patients. “ HIV-associated tuberculosis can be controlled by better scale up and implementation of tools that are currently available. For example, we need to get more HIV-infected people earlier on to antiretroviral therapy as this is a most important way of preventing tuberculosis. In the high HIV-TB burden areas of Southern Africa, the TB preventive effects of antiretroviral therapy can be further increased by the addition of isoniazid preventive therapy. Notes Dr. Harries.

Dr. Harries advises that all patients with Tuberclosis be tested for HIV/AIDS and those found positive be put immediately on anti-retroviral theraphy to curb related deaths. “We need to test all patients with tuberculosis for HIV, and those who are HIV-positive need to start antiretroviral therapy and cotrimoxazole preventive therapy as soon as possible. We have made good progress over the years in our fight against HIV-associated TB, but only by attaining universal coverage and meeting ambitious targets set by the international community will we achieve victory”. explains the expert.

Why TB-HIV is a critical public health issue ?

Available statistics indicate that 5.3 million people were living with HIV in 2012 and approx. 1/3 of them have latent tuberculosis infection. HIV is the strongest risk factor for developing active TB disease. Despite the fact that TB is curable and HIV is treatable, 320,000 people co-infected with the two diseases died in 2012.

TB remains a leading cause of death among people with HIV/AIDS, which caused 1.6 million deaths in 2012. The two diseases are closely linked because TB is frequently the first opportunistic infection in people living with HIV (PLH). An estimated 1.1 million people needed simultaneous treatment for both diseases in 2012 — 75% of them in the African Region. Early diagnosis, timely initiation of treatment for both diseases and careful monitoring are essential to treat TB in PLHs and identify HIV infection in people with TB.

In 2012, 4.1 million enrolled in HIV care were screened for TB (up from 3.5 million in 2011). 46% of TB patients knew their HIV status. Of the TB patients found to be HIV+ in 2012, 57% were enrolled on antiretroviral treatment (up from 49% in 2011). 80% received cotrimoxazole preventive therapy (CPT). 9.7 million people in low- and middle-income countries are on antiretroviral therapy (ART), but 16 million more are eligible under new guidelines and have no access to it. Barriers to intergrated TB-HIV care. The main obstacles to managing patients with TB and HIV infection are weak coordination between TB and HIV programmes and slow integration of collaborative TB-HIV services into the general health services. These challenges may have an adverse impact on patients’ treatment access and outcomes.

The UNAIDS global report 2013 says, an estimated 35.3 (32.2–38.8) million people were living with HIV in 2012. An increase from previous years as more people are receiving the life-saving antiretroviral therapy. There were 2.3 (1.9–2.7) million new HIV infections globally, showing a 33% decline in the number of new infections from 3.4 (3.1–3.7) million in2001. At the same time the number of AIDS deaths is also declining with 1.6 (1.4–1.9) million AIDS deaths in 2012, down from 2.3 (2.1–2.6) million in 2005.

Joseph Elunya, The Continent Observer, Uganda 
Citizen News Service - CNS
(First published in The Continent Observer, Uganda on 30th November 2013)