First scientific evidence how TB impacts people living with HIV came in early 1980s - soon after first HIV case got diagnosed in the world. But even today we are grappling with the sad reality that TB, being preventable, treatable and curable, is still the lead cause of death for people living with HIV. "We have been trying over the years to integrate TB and HIV but we have not got it right yet. When we have targets for HIV then we have targets for TB too - we have a clear direction where we are going around the two epidemics. I think it is time to start having honest conversations on how best to integrate them at country level" reflected Maurine Murenga, who was in conversation with CNS Health Editor Bobby Ramakant.
People living with HIV have heightened vulnerability to TB so TB preventive therapy as well as TB diagnostics, treatment and care services must reach them all. Other key populations who are at elevated risk of TB should also get full spectrum of TB services including TB preventive therapy.
"We need to identify people-centred interventions. We have to understand the people, their needs, complexities with which they live, and understand what works best for them" rightly emphasized Maurine Murenga.
Accountability begins from home
Multi-sectoral accountability framework is indeed key to monitor progress of governments, as well as all other stakeholders including civil society. "Communities also need to be working together, as I feel that we are together as community but back to back. There is no time to lose as we have to unite to deliver on the promise to end TB and AIDS. We already have the knowledge that treatment is prevention, especially in context of rolling out treatment for latent TB infection. Now we really need to step up and work together in order to ensure all evidence-based approaches and tools to prevent, diagnose, and treat TB, and latent TB, are maximally leveraged to end TB and end AIDS" rightly said Alberto Colorado, a noted TB and human rights advocate from TB Coalition of Americas.
Zero new infections and zero deaths of TB
Dr Suvanand Sahu, Deputy Executive Director of Stop TB Partnership, underlined the urgency warranted in efforts to end TB. By adopting the UN Sustainable Development Goals (SDGs), 193 countries have promised to end TB by 2030 (137 months left to achieve this target of TB elimination). India, with highest burden of TB globally, has ambitiously set the deadline to end TB nationally by 2025 (77 months to go). Urgency to cut the chain of transmission of TB infection was never so acute. We have to ensure that TB bacteria does not get transmitted from any patient to an uninfected individual. To achieve this zero transmission, we will have to provide accurate diagnosis and proper effective regimen that works for an individual, with full care and support without delay. We also have to ensure that no person with latent TB goes without being offered TB preventive therapy with dignity and respect to human rights. Ending TB is not just about meeting a deadline but is essentially a human rights imperative now.
Bobby Ramakant - CNS (Citizen News Service)
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