Today, Monday, March 24, 2014, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) joins the international community in commemorating World TB Day and those who have lost their lives to this terrible disease; TB is second only to HIV/AIDS in global deaths due to infectious diseases. Moreover, the World Health Organization estimates that at least one-third of the nearly 36 million people living with HIV/AIDS are also infected with TB. TB is the leading cause of death among people living with HIV in sub-Saharan Africa. With these two diseases so closely linked, the 2015 Millennium Development Goal of a 50 percent reduction of TB-related deaths is integral to achieving an AIDS-free generation.
Despite the staggering cost of lives due to co-infection between TB and HIV, we at PEPFAR, in conjunction with our partners implementing TB programs around the world, are encouraged to see progress over the past few years in combatting co-infection. In 2012:
- Rates of ART coverage among TB/HIV patients globally rose from 49 percent in 2011 to 57 percent.
- 4.1 million people enrolled in HIV care were screened for TB in 2012, up from 3.5 million in 2011.
- The percentage of TB patients who knew their HIV status rose from 69 percent in 2011 to 74 percent in sub-Saharan Africa.
The effects of co-infection between HIV and TB cannot be understated which is why PEPFAR addresses the deadly links between these two diseases as a top policy and programmatic priority. Our efforts are focused on prevention, care, and treatment programs as outlined in the 2012 PEPFAR Blueprint [PDF 2.83KB].
Key partnerships have played an instrumental role in scaling back TB and HIV co-infection. In August of 2012, PEPFAR announced a public-private partnership between USAID, UNITAID and the Bill & Melinda Gates Foundation. This partnership includes expansion and increased access to GeneXpert (Xpert), a molecular diagnostic system that provides a two-hour rapid diagnosis of TB, TB/HIV co-infection and drug-resistant TB. This partnership produced an immediate 40 percent reduction in the cost of this innovative rapid TB test, and a year and a half later is contributing to the roll-out of this new technology, increasing access to those most vulnerable.
With some of the highest TB/HIV co-infection rates in the world, the ongoing scale-up of Xpert in Zambia has provided early lessons that will inform further implementation of the diagnostic system. Managed by USAID and CDC, Xpert is now used in a total of 29 healthcare facilities, 14 laboratories, and eight prisons across eleven Zambian administrative districts. Moreover, patients screened with Xpert and diagnosed with active TB are being fast-tracked into treatment.
Successful initiatives and partnerships covering the most deadly global diseases of our time, including that of Xpert, underscore the United States’ continued prioritization of global health championed by President Obama and Secretary Kerry. In fact, the United States was the first and is the largest contributor to the Global Fund to Fight AIDS, TB, and Malaria and is also a major partner with the World Health Organization (WHO) , the Stop TB Partnership , and the Global Drug Facility , all of which provide important support for TB control activities worldwide.
Through innovations in science, key partnerships, and the tireless work of all those fighting for a 50 percent reduction in TB deaths by 2015 in conjunction with an AIDS-free generation, we have made real progress in tackling the staggering effects of TB and HIV co-infection. While PEPFAR knows much work remains, on this World TB Day we are optimistic about the work we are doing together to fight both TB and HIV.