TB is the leading cause of death for people living with HIV. Without treatment, 90% of people with HIV die within months of contracting TB. In spite of the close relationship between the diseases policy makers have been slow to respond – often providing testing and treatment for one disease, but ignoring the other. In many cases people are living with HIV, but still dying of TB.
In anticipation of World AIDS Day last week a number of MPs tabled parliamentary questions highlighting the issues around HIV/TB and the need to integrate services.
Andrew George MP, the Chair of the APPG on Global TB, asked the Government about the integration of TB and HIV diagnosis and treatment services. Parliamentary Under-Secretary of State, Stephen O’Brien MP, replied that DFID will continue to support programmes that focus on TB and HIV and strengthening health systems. He also highlighted that the Department will specify their objectives on tackling TB by May 2011.
Vice-Chair of the APPG, Annette Brooke MP, asked about HIV/TB co-infection and the impact on maternal and child health. The encouraging reply received from the Government Minister said that DFID supports an integrated approach to delivery of health services, including screening of TB and HIV as part of routine antenatal and postnatal care.
You can see these questions in detail and the Minister’s responses at this link.
With various reviews taking place and new business plans being established, it can be difficult to get a clear picture of what DFID is planning to improve coordination of HIV and TB services. As only 4% of HIV patients are being screened for TB, there is clearly a long way for donors, governments and implementing agencies to go to enhance integration of HIV and TB diagnosis. If the Maternal Health business plan, due to be published this month, does make a specific recommendation to screen all those receiving antenatal and postnatal care for both TB and HIV, this will be a big step forward.
May 2011 looks to be a key date when DFID’s objectives around HIV and TB will be laid out. With both diseases causing the unnecessary deaths of millions of people every year, one objective should be to produce a business plan addressing both diseases to set out a proper strategy for how DFID will tackle HIV/ AIDS and achieve the targets set out in the WHO revised Global Plan to Stop TB – to halve prevalence and death rates by 2015.