{"id":60813,"date":"2023-11-27T15:08:13","date_gmt":"2023-11-27T20:08:13","guid":{"rendered":"https:\/\/www.psi.org\/?post_type=news&p=60813"},"modified":"2023-11-27T15:08:15","modified_gmt":"2023-11-27T20:08:15","slug":"the-key-to-overcoming-the-dual-burden-of-tb-and-hiv","status":"publish","type":"news","link":"https:\/\/www.psi.org\/pt\/news\/the-key-to-overcoming-the-dual-burden-of-tb-and-hiv\/","title":{"rendered":"The Key to Overcoming the Dual Burden of TB and HIV"},"content":{"rendered":"

This piece originally ran on Devex<\/a><\/p>\n\n\n\n

Tuberculosis is the leading cause of death among people with HIV, so better integrating care for the two diseases is seen as crucial to ending TB.<\/strong><\/p>\n\n\n\n

For people living with HIV, tuberculosis is a big problem. It is the\u00a0leading cause of death among those with HIV<\/a>, who are 14 to 18 times more likely to fall ill with the disease than those without HIV, according to the\u00a0World Health Organization<\/a>. Latent TB infections can\u00a0more easily progress<\/a>\u00a0to full disease due to the weakened immune system of people with HIV. Around\u00a01 in 3 AIDS-related deaths in 2021 were also due to TB<\/a>.<\/p>\n\n\n\n

The dual risk has been on the global health community\u2019s mind in recent decades, with acknowledgment that the two diseases need to be tackled together: The provision of antiretroviral therapy, or ART, to people living with HIV and diagnosed with TB averted an\u00a0estimated 74 million deaths between 2000 and 2021<\/a>.<\/p>\n\n\n\n

Missing diagnoses<\/strong><\/p>\n\n\n\n

\u201cOne hundred percent, the two diseases have to be in people\u2019s heads together,\u201d said Helen Bygrave, a chronic disease adviser at M\u00e9decins Sans Fronti\u00e8res<\/a> who focuses on sub-Saharan Africa. \u201cThe integration of services has been a key element programmatically for MSF\u2019s work. The idea is to make sure everybody we\u2019re diagnosing with HIV is properly screened for TB and, likewise, anybody diagnosed with TB is tested for HIV and then appropriately started on ART.\u201d<\/p>\n\n\n\n

Having these facilities in the same place is crucial, said Bygrave, adding that this has improved over time. \u201cBefore we integrated care, what we saw is that people would just get lost in the system,\u201d she said. \u201cThat happens as soon as you have to refer somebody to another clinic room, another building or a different hospital.\u201d<\/p>\n\n\n\n

But despite these efforts, almost half of people with HIV <\/a>who developed TB in 2021 were not diagnosed or reported to have TB, while coverage of TB preventive therapy, or TPT, among eligible HIV-positive people stands at only 42%.<\/p>\n\n\n\n

Meanwhile, last year, MSF highlighted concerning signs of a reversal in progress in combating the two diseases, compounded by COVID-19<\/a> and global economic difficulties. Even before the pandemic, the organization had identified a crucial funding gap for HIV and TB response.<\/p>\n\n\n\n

\u201cThere\u2019s full recognition of the dual issue by donors, but implementation could still be better,\u201d said Bygrave. \u201cInvestment in treatment literacy needs funding too, with counseling in the clinic and education about people\u2019s diseases being areas of care that can always be done better.\u201d<\/p>\n\n\n\n

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