Stop-TB briefing for OAU Abuja Summit
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Dear colleagues,
Please find below a briefing-note with the main messages related to
the burden on TB/HIV and suggest action-points. We would like your
support in communicating and campaigning widely the need for joint
effort on TB/HIV.
This week offers an excellent opportunity since the African Heads of
State summit on "HIV/AIDS, Tuberculosis and Other Infectious Dis-
eases" will be held in Abuja, Nigeria from 24-27 April. Please feel
free to further disseminate the messages in the briefing-note for any
focal points that might be attending the Abuja Summit.
On Monday 23rd April, a joint WHO/UNAIDS press-release will be re-
leased to further highlight the importance of the TB/HIV issue.
The Stop TB Partnership Secretariat has initiated further communica-
tions activities, including:
* Stop TB materials to be displayed through the AFRO organized TB ex-
hibition;
* Stop TB website will highlight TB/HIV information as of Monday 23
April <http://www.stoptb.org>;
* Stop TB communique to be sent on Wednesday 25 April, will feature
outcomes of the TB/HIV working group held 9-11 April (will be send
out to over 2,000 addresses).
Please let us know of any press-releases, materials or activities
that you have available on TB/HIV or that you are planning in the
lead up to Abuja.
Your support and activities very much appreciated.
P. Heitkamp
The Stop TB Partnership Secretariat
World Health Organization
20, Avenue Appia 27,
CH 1211 Geneva, Switzerland
Tel: +41-22-791-2879/2385
Fax: +41-22-791-4886/4199
mailto:heitkampp@who.ch
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African Summit on HIV/AIDS, Tuberculosis and other related infectious
Diseases
24-27 April 2001
Abuja, Nigeria
Briefing note on TB and HIV-Stop TB Partnership
Background
The world has recently witnessed a massive increase in tuberculosis
(TB). TB cases are increasing 10% per year in Africa because of HIV.
Tuberculosis is a leading killer of people living with HIV/AIDS. Up
to 50% of people with HIV in sub-Saharan Africa develop TB - and 1
out of 3 dies of TB.
Control of TB and HIV in Africa are interdependent. Increasing access
to effective TB treatment through accelerated DOTS expansion improves
the quality of life for people with HIV and TB. Reducing transmission
of HIV will reduce the epidemic of TB. Joint TB/HIV activities are
needed to decrease the burden of HIV-related TB.
Action is urgently needed in three areas:
(a) Rapid DOTS expansion, primarily though community-based care ap-
proaches;
(b) Expand use of preventive therapy to prevent TB in people dually
infected with TB and HIV;
(c) Expand use of anti-retrovirals.
Experience in increasing access to TB drugs will make an enormous
contribution to HIV/AIDS care and support. The DOTS strategy provides
an excellent model for increasing access to anti-retrovirals. A key
principle of DOTS is effective standardized treatment regimens, pro-
vided in a supportive and patient-friendly environment, with direct
observation of treatment to maximize adherence and reduce drug resis-
tance.
Recent experience gained with the Global TB Drug Facility as a path-
finder for developing mechanisms for increasing access to TB drugs
whilst ensuring quality, reducing costs, and promoting rational use
will be invaluable for the development of similar systems for anti-
retrovirals.
Facts and Figures
1999 Global Estimates:
* 34.3 million people living with HIV/AIDS (two-thirds of these are
in Africa).
* Of these, 11.8 million people are co-infected with M. tuberculosis
and HIV.
* 8.4 million new TB cases occur every year (20% of these are in Af-
rica).
* 12% of these patients with TB are HIV-infected.
* TB is the leading cause of death in people with HIV.
1999 Africa:
* In some countries, up to 70% of TB patients are HIV-infected.
* Up to half of HIV-infected people will develop TB.
* Recent and rapid increase in TB in Africa is primarily due to HIV.
* By 2005 sub-Saharan Africa will have more TB cases (3.4 million)
than any other region.
Stop TB Partnership Response:
* Urgent attention needed for addressing TB and HIV together
The Stop TB Partnership notes with concern that acceleration efforts
are needed more widely to tackle TB when reducing the HIV burden. The
Stop TB Partnership is calling for the global community to actively
get involved in fighting TB and HIV/AIDS and join the Stop TB Part-
nership.
* Rapid DOTS Expansion
The Stop TB working group on DOTS Expansion is developing a global
plan to combat TB with a focus on high-burden countries (8 out of 22
in the world are in AFR). DOTS expansion focuses on scaling up TB
health service delivery and strengthening national and local infra-
structures to tackle TB.
* TB-HIV Strategy Development
The Stop TB working group on TB/HIV is developing a strategy and pol-
icy including operational research aimed at establishing the feasi-
bility, cost-effectiveness, and affordability of joint TB/HIV activi-
ties and their impact on the burden of HIV-related TB. For example,
the ProTEST Initiative (which aims at Promoting TESTing for HIV and
TB through voluntary testing and counselling) for increasing access
to a range of interventions for TB and HIV care and prevention.
* Research
Through the Stop TB partners, the Global Alliance for TB Drug R&D and
the TB Diagnostics Initiative, research, development and coalition
building for new diagnostic tests for TB, and new drugs and drug com-
binations will be emphasized. The development of research strategy,
provision of research capacity strengthening, and multi-centre field
trials will be supported to enhance activities tackling TB/HIV.
Strategy promoted by first meeting of Stop TB TB/HIV Working Group
(9-11 April 2001):
* Identify and promote TB and HIV common or complementary activities
at district level.
- Working group has endorsed a strategic framework for TB/HIV.
- Joint TB/HIV activities should be part of an essential package of
HIV/AIDS prevention and care.
- Strengthen collaborative TB/HIV initiatives wherever possible, and
further build on existing joint efforts such as ProTEST activities.
* DOTS strategy provides an excellent and proven model for delivery
of anti-retrovirals (where the DOTS strategy is not in place or not
functioning there is no chance to deliver long-term therapy to pa-
tients).
* Operationalize the use of TB preventive therapy and HIV anti-
retrovirals and document impact.
For more information please contact:
The Stop TB Partnership Secretariat
World Health Organization
20, Avenue Appia 27,
CH 1211 Geneva, Switzerland
Tel: +41-22-791-2879/2385
Fax: +41-22-791-4886/4199
mailto:heitkampp@who.ch
Please also visit the Stop TB Website:
http://www.stoptb.org
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