World AIDS Day, we must work together to defeat the dual epidemics of HIV and TB

Today, 1 December, on World AIDS Day, we are reminded of the need for the AIDS and tuberculosis (TB) communities to come together to drive down TB infections and deaths.

TB remains the predominant cause of death in People Living with HIV (PLHIV). In 2016, there were 374,000 TB deaths among PLHIV, which represents almost 40 per cent of all AIDS-related deaths. There is an urgent need to ramp up efforts to foster change, and to do so collaboratively.

The Union works around the world to help introduce systems to ensure TB and HIV are tackled together efficiently and in 2012 published a programmatic guide on implementing these activities.

To coincide with World AIDS Day, the latest edition of the Union’s International Journal of Tuberculosis and Lung Disease (IJTLD) features editorials addressing the current state of TB-HIV diagnosis and treatment and the measures necessary to improve these.

Jeroen Van Gorkom, The Union HIV Section chair, writes in World AIDS Day 2017, of the need to address the challenges faced particularly in many middle- and high-income countries, “Where HIV is a low prevalence disease concentrated in key populations affected by societal stigma and discrimination, in particular Eastern Europe and Asia, where HIV incidence continues to rise and access to anti-retroviral therapy (ART) is limited.”

“HIV and TB programmes need to strengthen their collaboration to ensure rapid diagnosis of both TB and HIV. Patient-centred care is critical for ensuring that patients are enabled to adhere to the treatments prescribed, and to minimise loss to follow-up and mortality.”

The need for approaches that tackle both diseases jointly is underscored by Dr Renee Ridzon, Associate Editor of The Union’s IJTLD, who writes in Test and treat for TB-HIV, that “Incorporation of TB screening and prevention into test and treat programmes should be a priority.”

Dr Ridzon concludes saying: “Good TB screening, prevention and treatment is essential for comprehensive HIV care and epidemic control, especially in sub-Saharan Africa.”

Dr Van Gorkum goes on to say: “Involvement of communities affected by TB and HIV in strategic planning and monitoring is key to achieving high quality patient-centred care”.

This sentiment was echoed by The Union’s Civil Society Liason Officer Noma Barnabas in a Union webinar held in the lead up to World AIDS Day, with Dr Linda-Gail Bekker, President of International AIDS Society and Dr Ishwar Gilada, President of the AIDS Society of India and founder and Secretary General of the People's Health Organisation.

Noma provided an important Civil Society perspective, also drawing from her personal experience as a TB survivor and PLHIV: “I had to take 13 tablets a day. As we move forward with all these efforts to combat TB-HIV we need improved regimens with reduced side-effects.

“As we strive to reach our targets, we must not forget that we are talking about human beings.” She said.

Watch the World AIDS Day webinar here

At The Union’s recent 48th World Conference, experts gathered in sessions devoted to showcasing the latest evidence and research on TB-HIV, including the application of such screening programmes.

The oral abstract session from diagnosis to outcomes - something for everyone contained a range of studies looking at treatment of TB and HIV, including a study in Nigeria looking at the use of geographic information system (GIS) mapping to inform interventions for epidemic control of TB-HIV co-infection.

A video of the session is available to watch here.

Another oral abstract session, HIV and TB: lessons from Africa featured a study in Kenya of TB screening, incidence and IPT among HIV-infected patients before and after ART initiation, demonstrating the need for increased uptake and implementation of screening services.

A video of the HIV and TB: Lessons from Africa session is available to watch here.