About 1% of HIV-positive people worldwide have been tested for tuberculosis

Aug 13 2008

Only 1% of people living with HIV/AIDS worldwide have been screened for tuberculosis, according to a report recently released by the coalition Advocacy To Control TB Internationally, or ACTION, Reuters reports.

The report, which is based on World Health Organization statistics, was released Thursday at the XVII International AIDS Conference in Mexico City.

According to the report, of the 33 million HIV-positive people worldwide, only 314,394 have been tested for TB, and of those screened, more than one in four were found to have active TB (Shankar, Reuters, 8/8). People living with HIV are 50 times more likely than HIV-negative people to develop TB, and without proper treatment, 90% typically will die within months, according to WHO data. None of the world's three largest HIV/AIDS donors -- the Global Fund To Fight AIDS, Tuberculosis and Malaria; the President's Emergency Plan for AIDS Relief; and the World Bank -- requires mandatory TB testing for HIV-positive individuals (IRIN/PlusNews, 8/8).

Researchers from ACTION at the AIDS conference said the low TB screening rate is "unacceptable." The group recommended universal TB screening for HIV-positive individuals, along with access to the three "I"s: intensified TB case detection, infection control and isoniazid preventive therapy. According to Jim Yong Kim, chief of the Division of Social Medicine and Health Inequalities at Harvard Medical School, screening tests for TB are inexpensive compared with the cost of antiretroviral drugs. Kim added that an integrated approach is necessary to address HIV/TB coinfection (Reuters, 8/8). Advocates at the AIDS conference also called on global leaders to commit to universal access to high quality HIV/TB care by 2015 (ACTION release, 8/7).

According to Kim, the initial pressure to deal with HIV/AIDS led to HIV services developing separately from TB services. "But now the focus needs breadth," Kim said, adding that people living with HIV need a "full range of public health services, including TB care." Kim noted that TB diagnosis tools may be outdated but that HIV programs could perform better even with existing TB diagnostic technology. "TB is a very curable disease," Kim said, adding that even extensively drug-resistant TB can be treated, according to a study conducted in Peru. "It is a crime for people with access to [antiretrovirals] to continue to die from TB," Kim said. Vuyiseka Dubula, secretary general of South Africa's Treatment Action Campaign, added that "[i]gnoring TB screening and care undermines all the gains made in HIV treatment," (IRIN/PlusNews, 8/8). According to Michel Sidibe, assistant secretary general and deputy executive director of UNAIDS, TB is a "preventable plague inside a devastating epidemic" (Reuters, 8/8).

In an effort to address HIV/TB coinfection, several HIV/AIDS and TB advocacy groups at the AIDS conference collected more than 10,000 postcards signed by people affected by HIV/AIDS and TB. The postcards will be sent to heads of the Global Fund, PEPFAR and the World Bank, as well as to the ministers of health in four countries -- Botswana, Kenya, Nigeria and South Africa -- with high HIV and TB burdens (ACTION release, 8/7).

The report is available online (.pdf).

Kaisernetwork.org was the official webcaster of the XVII International AIDS Conference in Mexico City.