TB-HIV letter to Mr. Michel Sidibe,new UNAIDS Executive Director

[Guest guest]

Dear Mr. Sidibe,

Congratulations on your recent appointment to lead UNAIDS and the global

response to HIV and AIDS. On behalf of the undersigned, we are writing to

request your bold leadership and commitment to achieving universal access to

quality TB/HIV prevention, diagnosis, and treatment services in the coming

years in coordination with Universal Access on HIV/AIDS by 2010.

As you know, tuberculosis poses one of the greatest risks to people living with

HIV. Although preventable and curable in most cases, TB is the biggest killer

of people living with HIV (PLWHA). In sub-Saharan Africa,

up to 50% of people living with HIV will develop TB, and without proper

treatment, approximately 90% of them will die within months.

It is clear that the fight against AIDS will not be won without also fighting

TB--a reality the HIV community has known for over two decades. Centrally

important is the continued roll-out of ARVs for co-infected people as one of

the best strategies for reducing the burden of TB among people living with HIV.

We must reach the country-level targets of Universal Access by 2010. However,

we continue to see people living with HIV dying unnecessarily of TB. A

Universal Access approach that does not include comprehensive TB services will

continue to leave hundreds of thousands of PLWHA to die of a disease that has

been curable for over half a century.

On numerous occasions over the last decade, UNAIDS, the World Health

Organization, and global leaders have committed to accelerating the scale-up of

critical TB/HIV interventions, but both action and impact remain grossly

inadequate. According to the World Health Organization’s

2008 Global TB Report, less than 1 percent of people living with HIV/AIDS were

screened for TB. HIV/AIDS programs are also failing to provide isoniazid

preventive therapy to protect PLWHA from TB. ARV clinics--which should be a

symbol of life--threaten to become places where people contract TB in high

numbers without quality infection control measures. Moreover, most programs

continue to rely on passive TB case finding, which translates to countless

preventable deaths and allows transmission to continue unabated. In the

multi-sectoral response to HIV, tuberculosis continues to be left aside—-rarely

incorporated into workplace, harm reduction, youth services, etc. Globally, we

do not even have accurate data on the true scope of the TB/HIV pandemic and the

response to date.

All of these are areas in which UNAIDS and its co-sponsors should be courageously

leading the way. Collaboration between TB and HIV programs is essential, not

only for an effective AIDS response, but also to bolster laboratory capacity,

human resources, and other health systems components.

According to the World Health Organization, full coverage of existing

screening, treatment, prophylaxis, and infection control tools could reduce the

number of TB-related deaths among HIV positive people by 80 percent--saving

hundreds of thousands of lives every year--and would cost $19 billion by 2015.

This goal, as well as promoting the search for new tools that work for PLWHA,

should be a key priority for UNAIDS. We acknowledge the recent work of the

UNAIDS secretariat to highlight TB/HIV and the Programme Coordinating

Board’s attention to these issues at their meeting in April 2008 and the

outcomes of the June 2008 HIV/TB Global Leaders Forum, but so much more can and

must be done to start saving lives now. In your new role, we request your bold

leadership to develop and implement a concrete, funded plan of action for

UNAIDS to achieve universal access to quality TB/HIV services.

We offer our partnership and support to you in this effort and welcome the

opportunity to work together to ensure that UNAIDS, at the Secretariat and

country level, is advancing quality TB/HIV care for all PLWHA as their right.

We ask that as soon as possible, ideally within your first year in the

position, you:

• Bring together a high level meeting of people within the UN,

governments, experts, civil society, and affected communities to craft a plan

of action to reach universal access to high quality TB/HIV services and full

adoption of the “Three Is.” This plan must have clear activities,

milestones, a plan to fund scale-up, and must be coordinated first and foremost

at the national level.

• Integrate TB/HIV into the central surveillance and reporting mandates

of UNAIDS to ensure that we have real and accurate information and projections

about the co-pandemics with which to plan a response.

• Invest seriously in TB/HIV within UNAIDS by increasing the budget,

expanding the staff, and making TB/HIV roll-out among the central goals in

UNAIDS work plans in all regions.

• Integrate TB into the multi-sectoral global response to HIV

(e.g.education, prisons, workplace, gender, children and youth, migration,

etc.)

• Expand support for technical assistance to countries preparing Global

Fund grants to incorporate TB/HIV services while also working to reach the goal

of 70% success.

With your personal leadership and commitment, these and other key interventions

by UNAIDS will dramatically improve the world’s response to TB/HIV and

save millions of lives. We look forward to supporting you in this critical

effort and working together to fight HIV/AIDS.

Sincerely,

AIDS Care Watch Campaign (ACW)

AIDS & Rights Alliance of Southern Africa

(ARASA), South Africa

Associacao de Reintegracao dos Jovens/Criancas na Vida Social (SCARJOV)

Aurum Institute for Health Research,

USA?

Children Concern

Community Based TB Action Group (CoBTAG), Zambia

Conseil Mondial de Soins, Democratic Republic of the Congo

The Consortium to Respond Effectively to the AIDS TB Epidemic (CREATE), USA

EMPOWER, India

Gambia Network of AIDS

Support Societies (GAMNASS), The Gambia

Global Health Advocates, France

The Global Youth Coalition on HIV/AIDS (GYCA), Global

Health & Development Networks (HDN)

HealthGAP (Global Access Project), USA

KNCV Tuberculosis Foundation,

Netherlands

Medical Care Development Inputs, Kenya

RESULTS Educational Fund, USA

RESULTS UK, United Kingdom

Stop TB Italia, Italy

Stop TB and HIV/AIDS, The Gambia

Target Tuberculosis, United Kingdom

Treatment Action Campaign, South Africa

Treatment Action Group, USA

TRT-5, France

United Civil Society Coalition on HIV/AIDS, TB, and Malaria (UCCATM), Kenya

Vanderbilt Institute for Global Health,

USA

Vivir, Participacion, Incidencia, y Transparencia, Mexcio

Cross posted: ITPC

Forwarded by:

---------------------------

Yours in Global Concern

A.SANKAR

Executive Director - EMPOWER.

TUTICORIN - 628 008, TN, INDIA

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www.empowerindia.org

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