South Africa: Activists Lament Lack of HIV/TB Co-Treatment

On World TB Day, March 24, activists marching on Cape Town's Parliament called on the government to devote more time and resources to the dual epidemics of HIV and TB. Most of the country's public health facilities continue to treat the diseases independently.

According to UNAIDS, 5.7 million South Africans ages 18-49 were living with HIV/AIDS in 2008. The country has a TB case rate of 940 per 100,000 people -- far above the 200 per 100,000 the World Health Organization classifies as a "TB emergency zone." Treatment Action Campaign (TAC) data show 54 percent of people who are HIV-positive in South Africa are co-infected with TB.

TAC and the TB/HIV Care Association are asking the Department of Health to integrate testing and treatment of the two diseases. According to TAC, just a quarter of HIV patients are screened for TB during clinical visits.

Liz Thebus, a nurse in Cape Town's public health sector for 30 years who now works for the Desmond Tutu HIV Foundation, said the need is urgent. "TB and HIV go hand in hand. Everyone knows it. So many people who are living with HIV are dying of TB, despite the fact that the disease is completely curable," she said. "Every clinic, hospital, and other medical facility in South Africa should be able to test and treat people for both diseases."

"Health care workers should receive proper training when it comes to diagnosing TB in people living with HIV," said Thebus. Since TB skin tests do not always indicate disease in HIV-infected patients -- "sometimes their immune systems are too weak to respond to the test," she explained -- additional screenings may be necessary. "Health care workers should be taught to look further than the first test results, especially if a patient is symptomatic," she said.

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