TB / HIV

Tuberculosis and HIV/AIDS are both major public health problems in the South-East Asia Region of WHO. Of the 20 million people suffering from active TB globally, 8 million are in this Region. Each year, three million new cases of TB are added and nearly three-quarters of a million die of the disease. At the same time, the Region is home to nearly 6 million people living with HIV/AIDS or nearly 18% of PHA, the largest proportion following sub-Saharan Africa, making it the second highest Region affected by HIV in the world.

On the first World TB Day of the new millennium, ministerial representatives of the 20 countries carrying 80 percent of the global tuberculosis (TB) burden adopted the Amsterdam Declaration to Stop TB. By adopting the Declaration, these governments pledged to take bold new steps in addressing the TB epidemic in their countries and affirmed their commitment to “implement, monitor and evaluate” their national TB programs according to the TB con- trol strategy recommended by the World Health Organization (WHO).

OPEN SOCIETY INSTITUTE Public Health Program Public Health Watch Public Health Watch, a project of the Public Health Program of the Open Society Institute, aims to strengthen meaningful and sustained engagement by infected and affected communities in the development, implementation, and monitoring of TB and HIV policies, programs, and practices.

This guideline module is for use in caring for patients with TB disease at first-level health facilities (health centres and the clinical team in district outpatient clinics) in countries with high burden of HIV. It addresses the care of both HIV-positive and HIV-negative patients with TB disease.

This book leads us to think And brings hope to patients We’re clear what it mentions With passion we’ll work together If patients get HIV testing We can have better TB monitoring Treatment and control will progress Bringing benefits to all of us.

The HIV/AIDS epidemic is still at a low level in the countries of Central Asia, but this situation presents a dual challenge: first, to call attention to the projected epidemic so that policy-makers at the national level understand what lies ahead, given international evidence on the growth of HIV infection; and second, to plan, in the context of extremely limited resources, a rational response to HIV/AIDS throughout the sub region. In Central Asia, as in the rest of ECA, the epidemic is rather significantly under-measured, but it is clear to all that HIV incidence is increasing, following epidemics of intravenous drug use (IDU) and sexually transmitted illnesses (STI) throughout these countries.

HIV epidemic is the single major reversal in human development in modern history. In most heavily affected countries, HIV has drastically reduced life expectancy even by more than 20 years. The estimated number of persons living with HIV in the world in 2007 was 33 million (30 million –36million).
The highest burden was in Sub Saharan Africa (67%) followed by South and South East Asia.

The global HIV epidemic has emerged as a formidable challenge to public health and development of the SAARC Region too. SAARC Region has an estimated 2.49 million People Living with HIV/AIDS (PLHA) and India alone bears an estimated 2.31 million of that. HIV epidemic in the SAARC Region is
a collection of different epidemics in Member States with their own characteristics and dynamics. The diversity existing in the region needs to be fully addressed and defined, in order to achieve the success in prevention and control activities.

The importance of HIV surveillance among tuberculosis (TB) patients is increasingly being recognized as the HIV epidemic continues to fuel the global TB epidemic. In many countries the HIV prevalence in TB patients is a sensitive indicator of the spread of HIV into the general population. Information on HIV levels in TB patients is essential to respond to the increasing commitment to provide HIV/AIDS care and support, including antiretroviral therapy (ART), to HIV-positive TB patients.

The HIV epidemic has posed major challenges to tuberculosis (TB) control efforts globally. Increasing TB case rates over the past decade in many countries in sub- Saharan Africa are largely attributable to the HIV epidemic. The extent of the HIV/TB epidemic in South-East Asia will depend on the future course of the HIV epidemic, as well as on efforts to control TB. Preventing HIV-associated TB means going beyond the full implementation of DOTS. It includes preventing HIV infec- tion, preventing progression of latent TB infection to active disease and the provision of HIV/AIDS care and antiretroviral treatment (ART).

Tuberculosis (TB) continues to be one of the most important global public health threats. The World Health Organization (WHO) estimates that the incidence of TB increased by 5 percent between 1997 and 1999, from 8 million to 8.4 million new cases. African countries severely affected by the HIV epidemic experienced a 20 percent increase in the incidence of TB; this rise is largely responsible for the TB increase globally.