The dual HIV-TB epidemic has posed a challenge for both TB and HIV efforts at all levels. Although the number of people living with HIV (PLHIV) screened for TB increased almost 12-fold, (from nearly 200 000 to over 2.3 million people) and testing for HIV among TB patients increased 5-fold (from 470,000 to over 2.2 million) between 2005 and 2010, almost a quarter of all AIDS deaths every year are still caused by TB despite it being preventable. An estimated 910,000 lives were saved globally over the last six years through the implementation of collaborative TB/HIV activities, yet only 46% of TB patients living with HIV received ART in 2010. Not all people living with HIV who enrolled into care were screened for TB and a far smaller proportion received isoniazid preventive treatment (IPT). In many high burden countries there has been little progress in the implementation of collaborative TB/HIV activities. 

During the opening plenary session of XIX International AIDS Conference (AIDS 2012), Secretary of State of USA Hillary Rodham Clinton made a fervent appeal to end the epidemic of AIDS and hoped to be able to stop the AIDS Memorial Quilt (which has the names of all those Americans who have died of AIDS) from growing any further. It is disappointing that not one of the distinguished speakers made even a passing reference about the need to control the spread of the tuberculosis (TB) bacteria, which stalks the earth hand in hand with the HIV virus and is the biggest cause of deaths among people living with HIV (PLHIV). Activists and health advocates however used this major opportunity to draw attention to TB/HIV by wearing face masks when Clinton was speaking. This activism has put the spotlight once again on the urgent need for better access to and research on life-saving tools and programs to fight TB/HIV. 

Recent advances in biomedical HIV, hepatitis C virus, and tuberculosis prevention and treatment are not reaching those who need them most; Political leaders continue to break domestic, global health commitments.

ACTION’s new publication, The Global Fund: Progress at Risk, provides specific examples of where the fight against TB will slow unless donors contribute needed resources.

A negative tuberculin skin testing (TST) result, as defined by a reaction of less than 5 mm of induration by Mantoux testing, is strongly predictive of active tuberculosis (TB)-related death in children. Treatment for TB should be administered if other signs of TB are present, irrespective of the TST result, according to the findings of a retrospective study.

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.

Pakistan ranks sixth globally among the 22 high tuberculosis risk countries, contributing 43 per cent of the disease towards the Eastern-Mediterranean region, according to the World Health Organization (WHO).

As 15 Southern African heads of state prepare to sign the Declaration on TB in the Mining Sector in Maputo, Mozambique, on 18 August, leaders from the government, scientific and private sectors will gather in Washington DC next week poised to convert political momentum into action.

The We Can End AIDS Mobilization for Economic Justice and Human Rights is on Tuesday, July 24 at 12 noon. TB advocates should join the Sound Policies branch, leaving from the Archives Metro station (see map here: http://www.wecanendaids.org/map.html).