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Global solidarity to stop TB and HIV
This year’s theme World AIDS Day is “Global Solidarity, Elastic Services”. At the 2016 UN High-Level Meeting on the Elimination of AIDS, Member States pledged to reduce TB mortality among people living with HIV by 2020 compared to 2010. Estimates for 2019 suggest that significant progress has been made with a 63% reduction; however, the 2020 target is unlikely to be met, especially in the context of the current COVID-19 pandemic.
A special message from the World Tuberculosis Program on the occasion of World AIDS Day
This year’s theme World AIDS Day is “Global Solidarity, Elastic Services”. At the 2016 UN High-Level Meeting on the Elimination of AIDS, Member States pledged to reduce TB mortality among people living with HIV by 2020 compared to 2010. Estimates for 2019 suggest that significant progress has been made with a 63% reduction; however, the 2020 target is unlikely to be met, especially in the context of the current COVID-19 pandemic.
The primary factor in TB mortality among people with HIV is late diagnosis. This year’s WHO World Tuberculosis Report highlighted that globally 44% of people with HIV-related tuberculosis were not diagnosed in 2019. Autopsy studies among people who have died of AIDS report that almost half (46%) of them have tuberculosis that was not detected before death. Therefore, increased detection of TB among people living with HIV is crucial. Preventive treatment of TB (TPT) among people living with HIV has been shown to significantly reduce the risk of developing TB and dying from it. There has been an impressive increase in TPT recently, but only 50% of people who started ART started TPT in 2019, and the vast majority of those who have already been on ART have just received it.
The impact of COVID on the response to TB and TB / HIV is palpable. Ongoing collection and analysis of TB data from 200 countries has shown reduced access to care in outpatient and inpatient settings, affecting the entire cascade of care, including prevention. COVID also affects the response to HIV and raises poverty and malnutrition, exposing people to an increased risk of TB and strengthening the argument for strong prevention measures. Strengthening the system for maintaining and strengthening HIV, TB / HIV and TB services is therefore even more important now given this potential negative impact of COVID-19.
Increased laboratory capacity, especially with increased availability of platforms such as chest X-rays and certain WHO-recommended rapid molecular diagnostic platforms that can be used to diagnose COVID-19 and TB, should be used to expand access to TB diagnosis, including for individuals. living with HIV. Similarly, the expanded institutional capacity for airborne infection control and contact search provides an opportunity to strengthen TB infection control and contact search. Likewise, the digital innovation and multi-month issuance experience required by the COVID-19 pandemic should be harnessed to catalyze the enhanced TB prevention treatment needed to accelerate progress in stopping TB.
Now, more than ever, we need to expand and strengthen the integration of services within primary health care, optimizing differentiated service delivery, community engagement and the use of digital technologies to reach those most at risk of TB and HIV through screening, prevention and diagnosis. and treatment.
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