The chasm between TB and HIV continues
SHOBHA SHUKLA, BOBBY RAMAKANT - CNS
"The two worst global health problems have combined forces well. But the institutions addressing them have miserably failed to put their act together," wrote Dr Tim France, a noted global health thought leader, in an op-ed article titled "The chasm between TB and HIV" which was widely published in several newspapers of high TB burden countries in Asia Pacific and Africa in 2006.
Even after 18 years since then, his words remain deeply relevant. Eamonn Murphy, Director, UNAIDS Asia Pacific and UNAIDS Eastern Europe and Central Asia, opened his keynote address in the End TB Dialogues Summit held recently, underlining the importance of bringing TB and HIV services together and strikingly called upon the dire need to 'break the silos' - a clarion call which Dr France had also unequivocally given through his op-ed of almost two decades back!
"Many of the [TB and HIV] programmes are operating in isolation and almost in conflict with each other and it is not helping the patients [co-infected with TB and HIV] we all serve. There are many missed opportunities for HIV and TB service access in Asia Pacific" said Eamonn.
Asia Pacific is home to 21% of those who are co-infected with TB and HIV. "One-third of HIV treatment service providers do not provide TB treatment and three-fourth of TB service providers do not provide HIV treatment. This gap has got bigger overtime, and we need to work collectively to bring this down and make the programmes connect and work together" said Eamonn.
"I have been to hospitals where in the compound you have a TB clinic in one part, and an HIV clinic in the other part - and the staff never talk. Only a quarter of countries in the Asia Pacific region include TB preventative treatment in their national HIV policies and guidelines," added Eamonn. Over 1.9 million people living with HIV had received TB preventive treatment in 2022 globally.
"The 'one patient two clinics' bottlenecks of TB HIV care - must become obsolete. There should be a commitment to joint programming that is a fully integrated model of care where all services for both TB and HIV are provided in a single facility and by the same service providers. We need to bring the 'silos' together," said Eamonn.
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