South Africa: Tuberculosis and HIV -- A Deadly Duo

In South Africa, some TB patients avoid seeking treatment for fear that their infection will be equated with HIV, and they will suffer discrimination. One South African dies from TB every hour, and 49 percent of South African TB patients have HIV/AIDS, according to the South African National Tuberculosis Association.

When a TB patient checks into a hospital, he or she is given the option to take an HIV test. Jenny Nash, a doctor at Meselini Hospital in Kwazulu-Natal, said approximately 70 percent of the TB patients treated by the hospital are HIV-positive. But the hospital, like many others, has not adopted a formal approach to treating TB patients in light of the HIV/AIDS epidemic.

In June, the 14th International AIDS Conference in Barcelona heard the call for the recognition of the synergistic relationship between HIV and TB, and criticized the inadequate efforts by governments and organizations to forge a combined, more effective response to these epidemics. "Tuberculosis infects one-third of the world's population and is now the leading cause of illness and death in people with HIV globally," according to Key Correspondent Team Health & Development Networks. It reported that in Africa the HIV epidemic is fueling a dramatic surge in TB, with new TB cases is increasing by 6 percent each year -- three times the global rate.

The World Health Organization and the Stop-TB Partnership have now developed a strategic framework to reduce the burden of TB/HIV. In 2002, WHO launched pilot sites in four African countries to deliver joint coherent interventions and programs for TB and HIV prevention and care. Based on the successful experiences from a number of these pilot sites, the Stop-TB Partnership proposes that a more unified approach be adopted in high HIV-prevalence countries.

Dr. Refiloe Matji, director of the TB control program at the Department of Health, says South Africa is starting to approach the HIV and TB epidemics jointly. "We have started to introduce HIV and TB communication pilot sites to ensure that the right message is given to patients." She says there is a stigma among TB patients that they are automatically HIV-positive as well. "We need just as much advocacy for TB patients as we get for HIV."

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