Increased Focus on TB Treatment Could Help HIV/AIDS Patients Live Longer, Opinion Piece Says
An "explosion" in the number of tuberculosis cases among HIV-positive people could be responsible for half of all AIDS-related deaths, and granting the disease "the respect it deserves offers a crucial, and unheralded, way of delivering hope to AIDS suffers," New York Times editorial writer Tina Rosenberg writes in an opinion piece for the Times Magazine. While TB "is still regarded as a relic," about two million people -- many of whom are HIV-positive -- die annually from the disease, according to Rosenberg. While antiretroviral drugs for HIV/AIDS treatment are expensive, treating TB with the strategy known as directly observed treatment, short-course -- a six- to eight-month treatment course developed in Africa in the 1980s and introduced by the World Health Organization in 1994 -- costs only about $11 and could allow HIV-positive patients to live "years longer" and "buy [them] years of health while they wait for antiretrovirals," Rosenberg says, adding that "[e]ven the poorest countries" can cure more than 90% of TB cases using DOTS. However, Rosenberg says that DOTS -- which is considered to be one of the world's most cost-effective health interventions -- is used "far too little" because many of the countries where the majority of HIV-TB co-infected people live are unable to employ DOTS. The program requires both an uninterrupted supply of drugs and mandates that clinics providing the treatment also provide a simple and low-cost method to diagnose patients, track and report progress and find ways to ensure that patients are taking the drugs every day for at least the initial two months of treatment.
HIV/AIDS, TB Offer 'Double Opportunity'
The "horrifying collision" of TB and HIV "offers a double opportunity to save lives" by combining treatments, which could provide a solution to "one of the most vexing problems in both the prevention and treatment of AIDS -- finding the sick and getting them testing and counseling," Rosenberg says. However, "TB is still invisible" both because of the lack of funding targeting the disease and because of the nature of the disease, which is curable and generally afflicts only the poor and prisoners, according to Rosenberg. The Global Fund to Fight AIDS, Tuberculosis and Malaria in its last round of grants allocated only 10% of the funds to programs aimed at fighting TB, according to Rosenberg. In addition, TB has no "citizen-activists," and doctors "who care passionately" about TB have been "working in a ghetto," Rosenberg says. "The world needs to join [the doctors'] battle -- both to stop a tuberculosis explosion and to save lives in the fight against AIDS," Rosenberg concludes (Rosenberg, New York Times Magazine, 9/19).