The end of AIDS? The deadly duo no one is talking about

Alarm bells are ringing in the international HIV community. We’re not getting to the end of AIDS, in fact we’re seeing rates of new infections rapidly increasing in some parts of the world, particularly Eastern Europe and Central Asia. There are many different reasons why. Donor de-prioritisation of HIV leading to decrease in funding is undoubtedly one of the top. A report by Kaiser Family Foundation and UNAIDS released before the conference describes the potentially devastating situation of international HIV funding decrease from $8.6 billion in 2014 to $7.5 billion in 2015, the first time a decrease has been seen in five years.

However, there is another reason that we’re not seeing the end of AIDS. Tuberculosis.

TB and HIV are a deadly duo, each epidemic heightens the risk and intensifies the damage of the other, and we’re not talking about it.

During AIDS2004, Nelson Mandela took to the stage with a simple statement that was emphasised by only a few in Durban, including Aaron Motsoaledi South African Minister of Health and Steven Lewis of AIDS-free World; “We cannot win the battle against AIDS if we do not also fight TB”.

But here we are, 12 years later. Taking advantage of compromised immune systems, tuberculosis is still the leading killer of people living with HIV. We’re not doing a good enough job of finding and diagnosing TB in people living with HIV. Almost unbelievably, 50% of the time someone living with HIV dies from TB, no-one knew they ever had the disease that killed them. 

Unacceptably, many of these deaths are entirely preventable and treatable. They should never happen.  

In Durban, the ACTION partnership, launched our newest research; From Policy to Practice: How the TB-HIV Response is Working. The report investigated whether the WHO’s recommendations for TB-HIV collaborative activities had been translated into commitments at global and national levels.  It shows that while countries have taken steps in the right direction to combat the deadly duo of TB and HIV, policy improvements have not all translated into changes on the ground.

 So why are so many people living with HIV but dying of a preventable and treatable disease? Why do we work so hard for advances in HIV medication to enable people living with HIV to live long and healthy lives only to have their final years snatched away by a disease we know how to stop?

We’re all at fault. Blame can and must be placed everywhere - donors, civil society, academics, technical agencies; all working their best to see the end of TB or HIV, but rarely both. The TB-HIV response has been slow on the uptake, and in no small part to the weak at best collaboration between people working on TB and people working on HIV.

The UNAIDS latest report, just released, titled “90-90-90: On the Right Track Towards the Global Target”, lays out how the HIV UN technical agency sees the end of AIDS by 2030. A noble target by any stretch of the imagination. However, the 54 page document forgoes one important concept when mentioning tuberculosis only once– that addressing TB is critical to the fight against HIV/AIDS.

Many people see TB as dull, TB as “not sexy”. The TB community has branded itself as extremely technical and medical (I mean, come on, we talk about sputum…) and that doesn’t make us sound fun to play with.

But I disagree - TB is anything but dreary. Try this. Turn to the person next to you right now. Tell them that TB, an airborne disease, kills more people than any other disease in history. Tell them that drug resistant TB is reaching unprecedented levels, with costs of almost $17 billion predicted to be wiped from the world’s economy by 2050. Tell them that the relationship between TB and HIV is killing over 1000 people every day. Tell them that despite all this, TB still receives desperately inadequate international funding to tackle the epidemic. Do they still think that TB is dull? My guess is no.

There is definitely hope. There are so many individuals and organisations determined and personally committed to removing these diseases from our futures, all so inherently devastated by the thought of one more person, one more mother, father or daughter, dying unnecessarily.

This conference could be the turning point. The time is now for everyone to take TB & HIV as common cause to join forces and take down this deadly duo once and for all.

Source: The Huffington Post