Nelson Mandela Says Global AIDS Fight Should Include Efforts To Combat TB; Gates Foundation Awards $45M for AIDS/TB Research
Global efforts to fight the HIV/AIDS epidemic should include efforts to combat tuberculosis -- which is often a "death sentence" for people living with HIV-- former South African President Nelson Mandela said on Thursday at the XV International AIDS Conference in Bangkok, Thailand, Reuters reports. About 14 million of the 38 million HIV-positive people worldwide are coinfected with TB, 70% of who live in sub-Saharan Africa, according to Reuters. Mandela said, "The world has made defeating AIDS its top priority. This is a blessing, but TB remains ignored." He added, "We cannot win the battle against AIDS if we do not also fight TB." Mandela said that TB is "too often a death sentence for people with AIDS," adding, "It does not have to be this way" (Schuettler, Reuters, 7/15). Mandela said that although a cure for TB has existed for the past five decades, what has been lacking is the "will and the resources to quickly diagnose people with TB and get them the treatment they need" (Joshi, Associated Press, 7/15).
The Bill & Melinda Gates Foundation on Thursday announced a $44.7 million grant aimed at curbing HIV-related TB, the Seattle Post-Intelligencer reports (Paulson, Seattle Post-Intelligencer, 7/15). The grant will go to the Consortium to Respond Effectively to the AIDS-TB Epidemics, or CREATE, which is led by researchers from Johns Hopkins University in Baltimore, Md., according to the Baltimore Sun (Bor, Baltimore Sun, 7/15). CREATE also includes researchers from the London School of Hygiene and Tropical Medicine, Aurum Health Research in South Africa, the University of Zambia, Stellenbosch University of South Africa, the Municipal Health Secretariat of Rio de Janeiro, in addition to the World Health Organization and CDC, the Wall Street Journal reports (Chase, Wall Street Journal, 7/15). The grant will fund three studies to evaluate the use of the antibiotic isoniazid on people living with HIV. One of the studies, which will recruit participants from Zambia and South Africa, will include school- and community-based TB education and examine the benefits of administering isoniazid to all members of a households that have TB patients. Another study, based in South Africa, will focus on the impact of isoniazid on gold miners in the country, and a study in Brazil will examine the effect of isoniazid on HIV-positive people with TB who are taking antiretroviral drugs (Gates release, 7/15). The standard treatment for TB is directly observed treatment, short course -- or DOTS -- which involves health care workers observing TB patients taking medicine daily over several months, according to the Post-Intelligencer.
Dr. Richard Chaisson, head of the JHU Center for Tuberculosis Research, said, "The traditional strategies for controlling tuberculosis don't work in communities with high rates of HIV." He added, "We're challenging the dogma here," saying, "The problem is that the dogma is not right and the DOTS approach is not enough." Dr. Helene Gayle, director of the HIV, TB and Reproductive Health program for the Gates Foundation, said, "We can't fight AIDS unless we also fight TB" (Seattle Post-Intelligencer, 7/15). "DOTS is great when HIV isn't a major problem. But once HIV moves in, control is undermined," Gayle said, adding, "DOTS just can't seem to catch up" (Wall Street Journal, 7/15).
A webcast of Mandela's speech, as well as additional coverage of the conference, is available online from kaisernetwork.org.
SABC News on Wednesday reported on Nelson's statements on HIV and TB coinfections (SABC News, 7/14). The complete segment is available online in RealPlayer