Promoting the Implementation of Collaborative TB/HIV Activities Through Public-Private Mix and Partnerships. Report of a Consultation Meeting Including an Implementation Protocol

摘要

Tuberculosis (TB) is a leading killer among people living with HIV (PLHIV). Of the estimated 9.2 million new TB cases and 1.7 million deaths from TB in 2006, 709,000 cases (8%) and 200,000 deaths (12%) occurred in PLHIV. The African Region accounts for 85% of the global distribution of HIV-positive TB patients. Collaborative TB/HIV activities are essential to ensure that HIV-positive TB patients are identified and treated appropriately; and to prevent, diagnose and treat TB in PLHIV. In recent years there has been considerable progress, particularly in the African Region, with the provision of TB/HIV interventions. In 2006, 12% of all notified TB patients were tested for HIV compared to 0.5% in 2002. Of the TB patients tested positive for HIV, 78% were treated with co-trimoxazole preventive therapy and 41% started treatment with antiretroviral drugs. However, scale-up of activities falls short of the targets of the Global Plan to Stop TB, 2006-2015. The expansion of life saving antiretroviral drugs in HIV prevalent and resource constrained settings have also been instrumental for the expansion of collaborative TB/HIV activities. By the end of 2007, 3 million PLHIV were put on antiretroviral treatment. It is also well-known that patients with symptoms of TB and HIV seek and receive care from a wide variety of health care providers outside of the national TB and HIV/AIDS control programmes, depending upon availability, acceptability, costs and many other factors. These include informal village doctors, private general practitioners, public hospitals, specialized physicians, non-governmental organizations (NGOs), medical colleges, corporate health services etc.