The evidence for the need for a fully integrated approach to fighting HIV/AIDS and TB has long been acknowledged. We know the facts: TB is the leading killer of people living with HIV. Without proper treatment, approximately 90% of people living with HIV will die within months of developing active TB.
HIV prevalence among TB patients has been estimated to be as high as 80%-90% in some areas of sub-Saharan Africa. In 2004, the WHO recommended increased collaboration between HIV and TB programmes, however, the WHO estimated in 2010 that still only about 5% of people living with HIV were screened for TB.
We also know the cross-cutting impact of TB and HIV/AIDS on maternal and child health. The impact of TB on the most vulnerable women and children is complicated by and intertwined with the HIV epidemic. In short – pregnant women living with HIV and active TB face far higher risks of maternal mortality than women without HIV infection. Mother-to-child transmission of TB is estimated to be 15% within three weeks of birth, and some studies suggest that TB in pregnant women living with HIV may increase the risk of HIV in utero transmission. Older children are also at increased risk of infection from care givers, and children are often pulled out of school to help care for sick family members or to provide additional income for the family. Children who are infected with HIV are especially vulnerable to TB disease, which increases the risk of child mortality. TB accounts for some 20% of all deaths in HIV-infected children.
DFID have taken steps to acknowledge the need for TB and HIV integration with the recently published Towards Zero Infections, The UK’s position paper on HIV in the developing world. However more often than not, the two diseases are still addressed separately within country level programming, and national and international policy and advocacy.
Aim of the Working Group
The aim is to establish a dedicated TB/HIV Working Group within the Consortium structure, working alongside the UK Coalition to Stop TB, to take this issue forward. The group will provide a forum for debate and discussion and facilitate that sharing of expertise on cross-cutting issues related to TB and HIV and AIDS in order to better influence more effective policy and practice.
To share and learn from the experiences of members, networks, people living with HIV and AIDS and TB, and external organisations to better understand the relationship between TB and HIV and AIDS and how they can be mitigated more effectively jointly.
To generate research to help understand more completely the exact relationship between TB and HIV and AIDS and to work to implement this research into a more sustainable method of addressing TB and HIV and AIDS in conjunction with similar problems, impacts and methods of mitigation.
To influence, and lobby when necessary, the policy and practice of external stakeholders including government agencies and international institutions.
Members of the UK Consortium on AIDS and International Development have a unique and important role to play in the TB/HIV response, but to date there has not been specific focus within the network to bring together organisations to facilitate dialogue, advocacy, information sharing and to move forward policy and programming recommendations.
The Power of Vaccines Event (2012)