HEALTH-AFRICA: TB and AIDS Campaigns Urged to Co-operate

By Miriam Mannak Reprint | | Print |

Miriam Mannak

CAPE TOWN, Nov 10 2007 (IPS) - Tuberculosis (TB) in Africa cannot be dealt with while TB and HIV/AIDS organisations refuse to set aside their differences, health experts said Friday during the 38th Union World Conference on Lung Health, underway in Cape Town, South Africa.

“So far, many TB and HIV programmes in Africa – or anywhere in the world – do not co-operate with one another, despite the strong connection that exists between HIV and TB,” noted Paula Fujiwara, senior technical advisor and director of the HIV department of the Union Against Tuberculosis and Lung Disease, the international coalition that has organised the Nov. 8-12 meeting, held annually.

“In some African countries for instance, 75 percent to 80 percent of the people living with TB are co-infected with HIV.”

Fujiwara said jealousy was one of the major factors in the lack of collaboration between the two camps: “HIV has always been the big kid on the block, with TB being the little brother. HIV programmes and organisations seem to be afraid that TB takes away attention and funding.”

TB is an airborne disease that principally affects the lungs; it is passed on, in part, through coughing and sneezing. Tuberculosis bacteria are able to remain dormant in a person, becoming active again in the event that the patient’s immune system is weakened, as in the case of HIV infection.

Active TB is highly contagious and although treatable, potentially deadly – especially for those who have AIDS. The disease is the leading cause of death among Africans infected with HIV: according to statistics from the World Health Organisation, 90 percent of people living with HIV/AIDS in Africa die within months of contracting TB.

It is estimated that 590,000 people die of TB each year in Africa, the only continent where TB rates are rapidly increasing. This is partially due to the high numbers of HIV infections in this region. Sub-Saharan Africa is home to more than 60 percent of HIV positive people worldwide.

In a bid to prompt HIV and TB activists to join hands, the Union Against Tuberculosis and Lung Disease has drawn up a strategy that allows the diseases to be tackled simultaneously – termed ‘Integrated Care for TB Patients Living with HIV/AIDS’ (IHC).

Collaboration in addressing TB and HIV and cross-testing of HIV and TB patients are central to the strategy, which is being tested in various countries, including the Democratic Republic of Congo, Zimbabwe and Uganda.

“In 2005, only seven percent of HIV patients worldwide were tested for TB,” said Alasdair Reid, HIV/TB advisor to the Joint United Nations Programme on HIV/AIDS.

“That is shocking. By testing people living with HIV for TB we can save thousands and thousands of lives each year. And, it is feasible. The problem is the lack of co-operation between the different organisations that deal with TB or HIV.”

A new model for distribution of funds is also required, Reid added. “Currently, money is raised for either HIV or TB, and funds dedicated for HIV can’t be used for TB or vice versa.”

“This has to change. When you want to tackle HIV you need to tackle TB, especially in Africa where so many people are co-infected.”

Winstone Zulu, an activist from Zambia who is living with HIV/AIDS, said the time had come for organisations to work together.

“We cannot successfully fight AIDS when we don’t fight TB,” he noted. “Unfortunately many people still don’t seem to understand the necessity of combating TB, especially in Africa. They do not see the connection between both diseases.”

“One needs to understand that in Africa, people are not dying because of HIV or AIDS. They are dying of TB,” Zulu added.

“I contracted TB in 1996 and it was truly the only disease in my entire life that nearly killed me. I have been living with HIV for 17 years and I have always been fine, due to the anti-retroviral treatment that I am taking. This all changed when TB hit me. The chest pains, the night sweats, the fatigue were unbearable.”

Anti-retrovial treatment comprises various drugs that prolong the lives of people who have contracted HIV.

“Luckily I received treatment on time and after a few weeks I felt much better,” said Zulu. “For four of my brothers, however, help came too late.”

The Cape Town meeting has as its theme ‘Confronting the challenges of HIV and MDR in TB control and care’.

MDR – multi-drug resistance – of TB is a source of growing concern among health workers and researchers, as is extensive drug-resistant tuberculosis (XDR-TB).

While Multidrug Resistant TB can withstand at least two of the main drugs used in initial treatment of the disease (termed “first-line drugs”), XDR-TB is also resistant to various second-line drugs.