focus news Compiled by Calvin Holbrook

Global Fund declares war on TB

A new Global Plan aims to wipe out the global domination of TB, one of the biggest killers of people with HIV



By the time you’ve read this opening paragraph, ten people will have caught TB (tuberculosis). According to the World Health Organization, TB is spreading at the rate of one person per second.
TB is one of the biggest killers of HIV positive people in the world and a third of the estimated 40 million people living with HIV are co-infected, the majority in sub-Saharan Africa. Each year almost nine million people worldwide are infected with TB and two million die needlessly from this curable disease because of lack of access to treatment.
World Stop TB Day takes place on 24 March this and every year to highlight these astonishing figures and the plight of those affected.
At the launch of the Global Plan to Stop TB 2006-2015 on 27 January in Switzerland, UK chancellor Gordon Brown, Nigerian President, Olusegun Obasanjo, and Bill Gates called on world leaders to rally behind this grand action plan. The main goals are to:
• Treat 50 million people
• Prevent 14 million deaths
• Introduce in 2010 the first new TB drug for 40 years
• Develop an effective and affordable vaccine by 2015
Brown called for the G8 to formally designate TB a top priority at its next meeting in July: “For far too long, world leaders have ignored the global TB epidemic, even as it causes millions of needless deaths each year.” But the Global Plan doesn’t come cheap: $56 billion is to be invested over the ten years, $7 billion of which will be heading for TB/HIV activities.

What is TB?
Tuberculosis is a disease of the respiratory system. It usually attacks the lungs, but it can affect almost any part of the body. A person with TB does not necessarily feel ill but the symptoms can include a cough that will not go away, feeling tired, weight loss, loss of appetite, fever, night sweats and coughing up blood.

TB and HIV
People with HIV are 50 times more likely to develop TB than the rest of the population. Paul Sommerfeld, chair of UK charity TB Alert, said: “The TB and HIV pandemics are intertwined. HIV and TB form a lethal combination, each speeding the other’s progress.”
TB accounts for about 13 per cent of HIV-related deaths, and in Africa, HIV is the single most important factor determining the increased incidence of TB in the past 10 years. Without proper treatment, approximately 90 per cent of those living with HIV die within months of contracting TB. But this isn’t just an African issue. In the UK, co-infection is estimated at around 10 per cent in all HIV cases. TB has been on the increase in the UK since 1987 and London rates have almost doubled, with some boroughs experiencing rates as high as China.

The cost: financial and human
TB treatment is one of the most cost-effective health interventions available. However, the cost can rise from $2,000 per patient with non-resistant TB to $250,000 for multi-drug resistant TB.
However, current tests for TB in those with HIV are only 40 per cent effective: the test looks for an immune response, so those already suffering with a depressed immune system may not show TB: many slip through the net.

Help stamp out TB
Visit www.stoptb.org to find out more about a World Stop TB Day event near you. For a personal account of living with HIV and TB co-infection, try Paul Mayho’s Tuberculosis Survival Handbook, out 22 March. TB Alert gets 10 per cent of all royalties.

• www.tbalert.org
• www.tbt.org (TB/HIV coinfection site)

Clockwise from below: launch of the Global Plan; promoting X-rays through posters; a co-infected TB/HIV patient, Thailand







How is TB spread?
• Like the common cold, TB is spread through the air after infected people cough or sneeze.
• Many people infected with the TB bacteria do not
develop the disease as their body’s defences protect them. Neither can they pass the disease on.
• However, TB can lie dormant in the body for many years and strike when the immune system is weak. If you are HIV positive, you are more likely to develop TB disease if you are
carrying the bacterium.