UNAIDS, WHO Call for Joint Treatment of HIV, TB That Could Prevent 500,000 Deaths in Africa Annually

Officials from the World Health Organization and UNAIDS on Monday called for the joint treatment of HIV/AIDS and tuberculosis, saying that combining testing and treatment of the two diseases could prevent up to 500,000 deaths in Africa annually, the AP/Yahoo! News reports. The organizations made the announcement at the opening of a two-day meeting in Addis Ababa, Ethiopia, that aims to promote joint HIV/AIDS and TB treatment initiatives. According to UNAIDS and WHO, the HIV/AIDS pandemic is "fueling a massive" TB crisis that could result in one billion TB infections worldwide in the next 20 years, according to AP/Yahoo! News. An additional 35 million people may die from the disease if it goes unchecked, according to WHO. Currently, 8.7 million people are infected with TB and two million people die from the disease annually worldwide. TB is the most common infection and cause of death among HIV-positive people, according to WHO. An estimated eight million of the 25 million HIV-positive Africans also are infected with the bacteria that causes TB. Each year, 5% to 10% of the eight million co-infected Africans develop active TB, and approximately four million co-infected Africans will develop active TB over the course of their lives. Currently, 8,000 people worldwide die from AIDS-related causes daily, while an additional 5,000 people die from TB every day. The "deadly interaction" of the two diseases is "compounded" by drug-resistant strains of TB, Mario Raviglione, director of WHO's Stop TB program, said, AP/Yahoo! News reports (Mitchell, AP/Yahoo! News, 9/20). "We cannot talk seriously about fighting AIDS while ignoring TB," Richard Feachem, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said, adding, "In Africa, TB and HIV collaborate to kill."

Existing Treatment Programs
National treatment programs in Africa are treating less than half of all HIV-positive people who are also infected with TB, according to UNAIDS and WHO, BBC News reports. Co-infected people usually die within months without treatment. Treatment programs in countries such as Ethiopia, Kenya, Mozambique, Uganda and Zimbabwe are treating less than 40% of co-infected patients. Less than 10% of co-infected people receive treatment in Nigeria. People living with HIV/AIDS respond "just as well" to TB treatments as HIV-negative patients, and a regimen of drugs to treat TB costs approximately $10 per patient, BBC News reports. In addition, "very few" TB patients are offered HIV tests, and "only a handful" receive antiretroviral drugs -- which should be a "standard" treatment for co-infected patients, WHO officials said, according to BBC News.

Proposed Treatment Programs
According to UNAIDS and WHO, combining the treatment of HIV and TB is "one of the best ways" to increase access to antiretrovirals and could help reach WHO's goal of treating three million HIV patients with antiretroviral drugs by 2005 under its 3 by 5 Initiative. "If we jointly tackle TB and HIV, we can be much more effective in controlling both diseases," UNAIDS Executive Director Peter Piot said (BBC News, 9/21). Officials also called on African governments to "rapid[ly] uptake" joint treatment programs to fight the two diseases, according to a WHO/UNAIDS joint release. TB treatment and diagnostic programs should be strengthened and designed to include HIV/AIDS counseling and testing, the organizations said. HIV/AIDS initiatives also should screen for TB, and preventive therapy should be provided to co-infected patients to prevent the development of active TB, according to the release (WHO/UNAIDS release, 9/21).

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