AIDS blights efforts to stop TB
Health experts have warned that the AIDS epidemic may cut back the significant recent gains made in the fight against tuberculosis (TB).
The growing number of people infected with HIV has fuelled a parallel rise in cases of TB, one of the world's oldest and most deadly infectious diseases.
In areas with high levels of HIV infection, TB cases have risen to as much as 10-fold in sub-Saharan Africa.
Worldwide, a third of the 36 million people with HIV/AIDS are infected with TB, which spreads as easily as the common cold. An estimated 2.6 million adults and children in the South-east Asia Region, and 194 000 in East Asia and the Pacific are infected with both TB and HIV. TB is also the leading cause of death among AIDS patients worldwide.
The warning comes at the start of the first joint meeting between health experts working in TB and AIDS in 11* countries in East Asia and Pacific. The three-day meeting beginning 2 October in Melbourne, organized by the World Health Organization (WHO), aims to promote joint efforts to fight the TB/HIV epidemic.
""These diseases are intricately linked,"" said the WHO's Regional Director for the Western Pacific, Dr Shigeru Omi. ""But in most countries, there has not been much interaction between AIDS and TB programmes.""
Two deadly diseases
TB already kills more people than any other infectious disease - more than 2 million globally every year. In the Western Pacific Region** alone, about 1000 people die everyday of TB.
Since the declaration of a ""tuberculosis crisis"" in the region in 1999, TB prevention has been stepped up through the WHO's ""STOP TB"" project. Its recommended strategy is a six-month medication course costing as little as $20. It aims to cut the millions of new TB cases in the Western Pacific Region by half by the year 2010.
TB control has already made significant inroads - in half of all provinces in China, TB cases have been reduced by 35% within six years. ""But if the HIV epidemic grows uncontrolled, those gains could be reversed,"" warned Dr Omi.
Experts have stressed that providing TB medication to AIDS patients would have the joint benefit of prolonging their lives as well as helping to control the TB epidemic. Untreated, someone with contagious TB can infect between 10 to 15 people a year.
Another proposal to be discussed at the meeting is for HIV testing to be provided to TB patients, and TB testing for HIV/AIDS patients. This would lead to better diagnosis of both diseases, and thus to treatment. The opportunities for such an approach are evident - TB is often the first manifestation of AIDS. Indeed, many people in developing countries learn of their HIV infection only when they become sick with TB.
WHO has also called for better collaboration between HIV/AIDS and TB programmes, so health care workers and facilities can co-ordinate the care given to patients.
With the risks of falling sick with TB so high among people with AIDS, programmes to provide TB preventive treatment to people with AIDS - even for those uninfected with the bacterium - will also be considered at the meeting.
For further information, contact Dr Gilles Poumerol. Regional Adviser, Sexually Transmitted Infections, including HIV/AIDS at (63 2) 528 9714 or email: firstname.lastname@example.org and/or Dr Dong-Il Ahn, Regional Adviser, Stop TB and Leprosy Elimination, at (63 2) 528 9855 or email: email@example.com
* The 11 countries attending the meeting are Cambodia, China, Laos, Malaysia, Mongolia, Philippines, Papua New Guinea, Korea, Singapore and Vietnam.
**The 37 countries and areas comprising the WHO Western Pacific Region are: American Samoa, Australia, Brunei Darussalam, Cambodia, China, Cook Islands, Fiji, French Polynesia, Guam, Hong Kong (China), Japan, Kiribati, Lao People's Democratic Republic, Macao (China), Malaysia, Marshall Islands, Federated States of Micronesia, Mongolia, Nauru, New Caledonia, New Zealand, Niue, Northern Mariana Islands, Palau, Papua New Guinea, Philippines, Pitcairn Islands, Republic of Korea, Samoa, Singapore, Solomon Islands, Tokelau, Tonga, Tuvalu, Vanuatu, Viet Nam, and Wallis and Futuna.