The Battle Against TB & HIV

The Battle Against TB & HIV

“We are all here because of our commitment to fighting AIDS. But we cannot win the battle against AIDS if we do not also fight TB. TB is too often a death sentence for people with AIDS.” -Nelson Mandela, 15 July 2004, XV International AIDS Conference, Bangkok

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In 1988 Nelson Mandela, received a tuberculosis (TB) positive sputum test while still imprisoned during the apartheid. His recovery from the not yet drug-resistant disease took over two years of treatment and although he survived the disease he did not survive it unscathed. The disease left him with damaged lungs making him susceptible to future infections.

Today we are faced with different types of TB such as the multi-drug resistant (MDR-TB) strain that is resistant to the two main types of anti-TB drugs, isoniazid and rifampicin, that has infected well over half a million people annually since 2012. Less than one in four of those infected were successfully diagnosed, posing a significant health threat to the others within their immediate circles. The ball doesn’t stop rolling at MDR TB, now we are also faced with extensively drug resistant TB (XDR TB), that is resistant to both first line and second line anti-TB drugs, making options for those whom contract it very limited. Individuals who are HIV positive are often times victims of the opportunistic qualities of TB, including those taking antiretroviral treatment. TB makes a significant portion of HIV related deaths; with Sub-Saharan Africa bear[ing] the brunt of the dual epidemic, accounting for approximately 75% of the estimated burden in 2012. Although many countries have made significant progress for reducing TB and HIV, the global reduction targets have not yet been met.

Worldwide the rate of children taking antiretroviral drugs to combat HIV is estimated at 34% compared to 68% in adults. Children, under the age of 15, account for 10% of all new global HIV infections.  Even more alarming, a recent publication from Harvard Medical School suggests worldwide TB cases in children to be nearly double than previously suggested and quantified that nearly one million children contract TB annually, contrary to the estimate of 500,000 in 2010.  Approximately 30,000 are estimated to have a multi-drug resistant strain. TB affects children differently than adults, with rapid progression from infection to disease and significant difficulty of diagnosis after the onset of symptoms, it is highly likely that a child will die before they even reach a healthcare provider.

The expansion of prevention and treatment programs is essential if the most vulnerable individuals in the population hope to be impacted.  Many public, private, and non-governmental organizations around the world are working to combat the global HIV epidemic by raising awareness, providing HIV testing, and give treatment and health services to at risk populations. But as Nelson Mandela said, the world has made defeating AIDS a top priority. This is a blessing. But TB remains ignored. Today we are calling on the world to recognize that we can’t fight AIDS unless we do much more to fight TB as well.

Meet some of the organizations working to reduce the global burden of HIV and TB. As they applied for the 2013 Children’s Prize, we’d like to take a moment and recognize the noble work they are doing.

Catholic Relief Services (The Gambia Program) is working to eliminate new pediatric HIV infections and improve maternal newborn and child health and survival.  They work to expand coverage of quality prevention of mother to child transmission services, based on national guidelines.  They respond to HIV and AIDS through home-based care, community prevention and mass-media activities.

Humana People to India works throughout the country in the areas of education, community development, microfinance, the environment, and of course health.  Humana People to India specifically works to reduce the risk of HIV transmission, and has intervention strategies that train community health care workers, counsels patients, and provides mass community information.

Lubangaber Community Medical Center and Preventive Services (LUCOMCEPS) is working in northern Uganda to support various health strengthening programs with the theme of giving back to the community.  The center offers free services including HIV/AIDS counseling and testing, antenatal care, post natal care, immunization, family planning, and health education.

Texas Children’s Hospital in collaboration with Baylor International Pediatric AIDS initiative (BIPAI) provides HIV/AIDS treatment for approximately 200,000 children in underserved areas, more than any other program worldwide. TCH and Baylor College of Medicine created the Texas Children’s Center for Global Health in March of 2011 to expand BIPAI’s mission beyond HIV/AIDS in a broad and unique initiative to improve the health of children around the world who suffer from a wide variety of inherited and acquired childhood conditions including sickle cell disease and HIV/AIDS infection.

University of Nairobi works with rural communities in Kenya to give all children a healthy start to life through innovations that support vaccination and reduce infant mortality at birth. They have successfully piloted a new system for child vaccination in rural Kenya villages to reduce the vulnerability of children under five in impoverished households headed by young mothers or older siblings whose parents have been infected with HIV. The University of Nairobi is embedded in a teaching, research, and national/regional think tank institution that provide intervention resources across the continuum of care for mother and child.


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