We Must Act to Save A Million Lives From TB-HIV

Tuberculosis (TB) has long been the Achilles' heel of the AIDS response, despite the fact that TB is curable with drugs costing about $25 in the developing world.
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This week marks the 30th anniversary of the AIDS epidemic. It can also mark a turning point in our fight against the disease. Just last month, an exciting new study demonstrated that providing early antiretroviral treatment (ART) for HIV can dramatically reduce the spread of new infections. We must scale up ART to save lives. But this alone will not be enough. On Monday night, as leaders gathered for the High Level Meeting on AIDS in New York, a scientific blueprint for interventions that will enable us to save a million more lives by 2015 was unveiled. These recommended interventions must also urgently be scaled up. The Stop TB Partnership -- an international association of over 1,600 members from the public, non-profit and private sectors -- released new scientific modeling which shows that with aggressive use of existing technology and tested interventions we can reduce TB-HIV deaths by 80 percent by 2015.

The bottom line: by making sure tuberculosis doesn't undermine AIDS treatment, we can save one million more lives by 2015.

Tuberculosis (TB) has long been the Achilles' heel of the AIDS response, despite the fact that TB is curable with drugs costing about $25 in the developing world. HIV -- the virus that causes AIDS -- and Mycobacterium tuberculosis -- the bacteria that causes TB -- work together to form a deadly super-epidemic, making TB the leading killer of people with HIV/AIDS. However, as AIDS treatment has expanded, TB and AIDS programs don't always work effectively with each other, and proven strategies have still not been taken to scale. Thirty years into the epidemic, too many people are now living with HIV only to die needlessly of TB.

Although one-third of the human population worldwide carries a dormant TB infection, in most cases this infection never makes the person sick, and it never spreads to others. But when HIV decimates the immune system, a latent TB infection is much more likely to explode into a deadly infectious disease that can be spread to others by coughing or sneezing.

Without treatment, most people with HIV who develop TB disease die within weeks.

World leaders now have an opportunity. They can save one million additional lives by working smarter and investing more now to fight TB-HIV together.

What should we do?

One key TB-HIV intervention is simple. Every time a person living with HIV receives clinical care for HIV, they should be screened for the signs and symptoms of TB, the infection most likely to kill them. And people with TB should be provided with HIV counseling and testing. Other interventions will require more ambition and resources, such as implementing game-changing new DNA-based TB diagnostics that can diagnose TB (including drug resistance) in hours instead of days or weeks.

We must commit the needed resources so that our global health investments follow the evidence. The U.S. Congress and other leaders must not be fooled by specious deficit arguments, when all the evidence shows that we are having an enormous impact and increased investment now can turn the tide of these epidemics. Congress should continue to increase investment in life-saving global health programs including the Global Fund to Fights AIDS, Tuberculosis and Malaria. Other donor countries must keep and expand their commitments to the Global Fund, and take on TB-HIV in their own bilateral AIDS programs. PEPFAR, the U.S. bilateral global AIDS program, is uniquely well placed to help drive these efforts and should invest more of its resources and use its leadership to drive the rapid scale up of TB-HIV services so that we can save a million lives by 2015. Countries with the greatest burden of co-infection must also urgently prioritize TB-HIV in their own budgets and bring real political leadership to this challenge. This new modeling shows what we can achieve -- how many more lives we can save -- if we have the will.

The opportunity is now. World leaders must commit to saving a million more lives from TB-HIV.

Learn more and take action at www.action.org

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