Joining forces to tackle TB and HIV: World TB Day, March 24th

[Guest guest]

World TB Day, March 24th

TB ANYWHERE IS TB EVERYWHERE is the theme for 2007 World TB Day,

March 24th, offering a message of urgency and shared responsibility.

Through unified action on all levels, we can work towards a world

finally free of tuberculosis.

The 2007 theme TB ANYWHERE IS TB EVERYWHERE emphasizes that although

TB is a preventable and curable disease, it remains a global

emergency. The theme reflects the chronically inadequate investment

in TB control, surveillance, research and development as well as TB's

deadly synergy with HIV.

The 2007 theme addresses the challenges to country TB programme

performance that affect TB control progress on a global scale.

Achieving the TB-focused targets of the United Nations' Millennium

Development Goals depends on effectively raising and addressing

country-level challenges through a unified global campaign.

In 2007, the World Health Organization will report on whether the

2005 global TB control targets of 70% case detection and 85%

treatment success have been achieved.

Fifty countries have met the 70% detection target and approximately

25 countries have met both targets. This success represents a major

landmark in TB control history and proves that TB control is

effective, even in countries with limited resources. The predicted

global average treatment success rate of 84% in 2005 is undeniably

good, and the case detection rate is likely to be 60% in 2005.

However, 1.5 million new infectious TB cases each year are still

being missed.

To help overcome the challenges that keep TB a global threat, there

is an urgent need to push for full funding of the Global Plan to Stop

TB (2006-2015) and work for implementation of the Stop TB Strategy.

It is time for all governments and the donor community to meet their

full responsibility to Stop TB, and for decision-makers to stand

alongside people and communities affected by TB.

The World TB Day theme includes a number of supporting messages that

are designed to emphasize the importance of:

• Improved endemic country financial contributions to TB control;

• Community involvement in the response to TB;

• Scale up of donor investment; and

• The need for decision-makers to protect communities from the threat

of extensively drug-resistant TB (XDR-TB) and HIV-related TB.

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Tuberculosis (TB) is one of the biggest killers of people living with

HIV and at least one third of the 39.5 million people estimated to be

living with HIV around the world are likely to be infected with the

TB bacteria. As a result of chronically poor investment in global TB

control a new strain of TB is emerging that has become resistant to

most of the available anti-tuberculosis drugs. Known as extensively

drug resistant TB (XDR TB) this strain has serious implications for

people living with HIV as it is almost untreatable in many of the

countries where it is occurring leading to very high death rates. WHO

and UNAIDS, together with other actors working on TB and HIV issues

are stepping up action to stop the spread of TB and this deadly new

strain.

TB is an infection which usually affects the lungs and is spread,

like the common cold, through the air from an infectious person

coughing, sneezing or even speaking. One third of the world's

population is infected with TB but only 5-10% of people who are

infected with TB actually develop TB disease during their lifetimes.

However, co-infection with HIV makes TB disease much more likely and

one in ten people infected with TB who also have HIV will develop TB

disease each year.

TB is treatable and can usually be cured in people living with HIV,

however some strains of TB bacteria have now acquired resistance to

one or more of the antibiotics commonly used to treat them; these are

known as drug-resistant strains. Treatment for these infections is

much longer and much more expensive. The recent outbreaks of

tuberculosis that is resistant to almost all of the available TB

drugs are giving serious cause for concern as this extensively drug

resistant strain (XDR TB) is virtually untreatable when it occurs in

people living with HIV and has a very high death rate.

UNAIDS has been following the developments closely. " We need to

rapidly ensure prompt diagnosis and effective treatment of TB for

people living with HIV in order to prevent drug resistance from

developing and spreading, " said UNAIDS' HIV/TB advisor, Alasdair

Reid.

TB drug resistance arises mainly because of inadequate TB control,

poor patient or clinician adherence to standard TB treatment

regimens, poor quality drugs or inadequate drug supplies. People

living with HIV are particularly vulnerable to developing drug-

resistant TB because of their increased susceptibility to infection

and progression to active TB.

At the 37th Union World Conference on Lung Health held in Paris in

November 2006, the interaction between TB and HIV and the threat of

extensively drug resistant TB featured prominently in the agenda. The

serious implications of the new strain of XDR TB for people living

with HIV were highlighted at a special plenary session held during

the conference. Dr De Cock, Director of WHO HIV/AIDS Department

said, " The recent emergence of a cluster of cases in South Africa has

demonstrated the high mortality that XDR TB can have when associated

with HIV infection. Countries with a high prevalence of HIV have been

responding quickly to draw up plans for managing and preventing drug-

resistant TB and this is welcomed. "

Because of the serious threat that TB and especially XDR TB poses for

people living with HIV, UNAIDS and the WHO HIV and TB departments are

joining forces to encourage a coordinated and concerted global effort

to control TB in people living with HIV.

WHO's Global Task Force on XDR TB have recently published a report

outlining measures needed to urgently combat extensively drug-

resistant XDR TB. It follows the announcement by WHO and its partners

that US$ 95 million will be required to implement the recommendations

in the report, to address the threat of XDR-TB in 2007 in southern

Africa. WHO have also released new guidelines on how to improve the

diagnosis of TB in people living with HIV.

Access WHO new guidelines.

http://www.who.int/tb/publications/2006/tbhiv_recommendations.pdf

Frequently asked questions about Tuberculosis and HIV.

http://data.unaids.org/pub/FactSheet/2006/TB_HIV_QA.pdf

Frequently asked questions about XDR-TB.

http://data.unaids.org/pub/FactSheet/2006/Q & A_XDR-TB.pdf

http://www.unaids.org/en/MediaCentre/PressMaterials/FeatureStory/20061

124_TB+and+HIV_en.asp