World TB Day: 3 actions for the HIV community
25 March 2019 – The global community is galvanizing efforts to raise the message: “It’s TIME to end TB”. This is the theme of World TB Day 2019, commemorated on 24 March.
Tuberculosis (TB) is not only the world’s biggest infectious killer, it is also the leading cause of death among people living with HIV. In 2017, TB was responsible for 32% of the 940 000 lives lost to HIV.
The WHO Department of HIV joins the global community in commemorating World TB Day 2019 by highlighting 3 key actions to be taken by HIV programmes across all countries and regions.
First – on prevention
Let us remember that people living with HIV are far more vulnerable (at least 20 times more) to TB infection than people without HIV. TB is preventable with effective TB preventive treatment (TPT), which reduces the risk of mortality by 37%. However, TPT is currently reaching fewer than 36% of the people in need. We call on all HIV programmes to increase provision of TPT to people with HIV.
Second – on diagnosis
Most people living with HIV are aware of their HIV diagnosis (75%). But, of the people with HIV who are estimated to have active TB, only 50% have been identified and are receiving care. Therefore, many people whose lives could be saved through HIV treatment are dying of undiagnosed TB. We urgently need to scale up TB diagnosis and strengthen referral and linkages to TB treatment at HIV service delivery points in all countries. This goes for all populations at risk, including children, pregnant women and marginalized groups, to ensure no one is left behind.
Third – on treatment
It is estimated that most of the people living with both TB and HIV miss out on life-saving treatment. Only 50% receive TB treatment, and only 41% receive HIV treatment (by comparison, the HIV treatment coverage rate among people living with HIV is 60%, globally). This shows how the deadly duo of TB and HIV is ravaging many of the most vulnerable people, including those with advanced HIV disease and those from marginalized populations who are struggling to access health care.
These 3 actions call for improved collaboration in countries across health programmes for more harmonized and integrated policies and service delivery. Unless HIV programmes scale up interventions to close these gaps in prevention, diagnosis and treatment, we will not meet our common targets – we cannot reduce HIV mortality from 940 000 in 2017 to 500 000 by 2020 without addressing the main cause: TB.
It is high time to take action! Let us work together to stop the needless deaths due to TB among people living with HIV.