Geneva -- On World Tuberculosis Day, 24 March, UNAIDS is urging countries to do much more to reduce the number of tuberculosis (TB) deaths among people living with HIV. TB is the most common cause of hospital admission and death among people living with HIV. In 2015, 1.1 million people died from an AIDS-related illness -- around 400 000 of whom died from TB, including 40 000 children.
"It is unacceptable that so many people living with HIV die from tuberculosis, and that most are undiagnosed or untreated," said Michel Sidibé, Executive Director of UNAIDS. "Only by stepping up collaboration between HIV and tuberculosis programmes to accelerate joint action can the world reach its critical HIV and tuberculosis targets."
Eight countries -- the Democratic Republic of the Congo, India, Indonesia, Mozambique, Nigeria, South Africa, the United Republic of Tanzania and Zambia -- account for around 70% of all TB deaths among people living with HIV. Scaling up action in these eight countries would put the world on track to reach the ambitious target in the 2016 United Nations Political Declaration on Ending AIDS of reducing TB-related deaths among people living with HIV by 75% by 2020.
Weaknesses in health systems are continuing to result in missed opportunities to diagnose TB among people living with HIV -- around 57% of HIV-associated TB cases remained untreated in 2015. Inadequate linkages to care after diagnosis, poor tracking of people and loss to follow-up, failure to reach the people most at risk of disease -- particularly marginalized populations, including people who inject drugs, prisoners and migrant workers -- and poor treatment outcomes contribute to the lack of progress. In 2014, around 11% of HIV-positive TB patients died, compared with 3% of HIV-negative TB patients. Early detection and effective treatment are essential to prevent TB-associated deaths, especially among people living with HIV.
Drug resistance is also a major concern -- in 2015, there were an estimated 480 000 new cases of multidrug-resistant TB. The recent approval of two new medicines to treat TB, the first in more than 60 years, is improving the outlook for people with drug-resistant TB.
UNAIDS calls for the elimination of TB deaths among people living with HIV and for health systems to be strengthened and services integrated to allow for a more rapid scale-up of HIV and TB programming. Countries must expand HIV prevention and treatment programmes that include regular TB screening, preventive therapy and early treatment, since they are simple, affordable and effective programmes that prevent TB deaths.
UNAIDS is continuing to support countries to Fast-Track their efforts to reach the critical 2020 targets of the 2016 Political Declaration. As part of these efforts, UNAIDS is urging countries to intensify action in 35 high-priority countries to accelerate results by implementing focused, high-impact programmes to advance progress in ending the AIDS epidemic.