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15 Jul 2003 14:36
The World Health Organisation (WHO) on Tuesday called for free anti-tuberculosis drugs (ATDs) and quality care to be made widely available to people living with HIV, along with renewed efforts to increase access to anti-retrovirals (ARVs) in developing countries.
Currently, tuberculosis (TB) is the biggest killer of people with Aids.
ATDs are a cocktail of medicines comprised of isoniazid, rifampicin, pyrazinamide and ethambutol that, when taken properly, are more than 95% effective in curing tuberculosis regardless of a person’s HIV status. ATDs cost only $10 per patient for the entire course of treatment.
Dr Mario Raviglione, acting director of WHO’s Stop TB Department, stressed that “Ten years after an unprecedented declaration of a global tuberculosis emergency by WHO, the TB epidemic has grown even worse, primarily due to the spread of HIV.
We need to increase our efforts to address the deadly synergy between the two diseases, each of which is fuelling the other’s impact.”
An estimated one third of the 42-million people living with HIV/Aids worldwide are co-infected with tuberculosis.
In Africa, HIV is causing tuberculosis to spread so rapidly that Dots TB treatment services cannot keep pace. HIV attacks the immune system, allowing the bacteria which cause TB to multiply and spread more easily. HIV is causing a 6% annual increase in the number of TB cases across sub-Saharan Africa. Meanwhile, Dots tuberculosis treatment services are also expanding but so far only at a rate of 2%.
According to Raviglione, the ATDs used with the Dots treatment strategy made it possible to cure tuberculosis in over 80 000 Africans living with HIV last year. However, more than 200 000 Africans with HIV died from tuberculosis because they had no access to ATDs and Dots services.
An even greater TB/HIV crisis may be emerging in India according to WHO. HIV is spreading rapidly in the country which has the largest number of TB cases in the world. There are already 180 000 Indians living with HIV who are also infected with TB. Fortunately, the Dots programme in India is one of the most rapidly expanding programmes in the world.
ATDs used through the Dots strategy can prolong the lives of people living with HIV by years at a cost of approximately $200 for the entire 6-8 month treatment period including health service and staff costs.
“In Africa, it strikes us as peculiar how politicians and academics can speak of ‘their Aids initiative’ or ‘their TB programme’ as if the two diseases are not related,” said Winstone Zulu, a Zambian man infected with HIV who had repeated bouts with TB until finally being cured of the disease with the Dots strategy.
“For me and my family, HIV and TB have always been seen together conspiring and collaborating to steal away our health.” - I-Net Bridge
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