'Strengthen TB control to tackle XDR-TB' among the key messages from global health leaders for World AIDS Day 2006
The threat posed by XDR-TB on people living with HIV features prominently in messages issued by health leaders to mark World AIDS Day.
In his first World AIDS Day statement as UN Secretary-General Special Envoy to Stop TB, Dr Jorge Sampaio, the former President of Portugal called for a "massive investment" in TB control and research:
"World AIDS Day is an occasion to acknowledge the incredible progress made towards ensuring access to life-saving anti-retroviral therapy, ARTs. But this promise of life of ARTs will be undermined if we do not ensure that a curable disease like TB is addressed effectively.
TB is the leading cause of death amongst people living with HIV/AIDS. The lethal combination of the two diseases makes it imperative that AIDS and TB programmes in affected countries work in close collaboration.
The recent identification of extensively drug-resistant TB, XDR-TB, and its devastating impact amongst those with HIV demonstrates the deadly synergy between these two diseases. It demands massive new investment to strengthen the current systems for TB treatment and hasten the development of new TB tools and the urgent implementation of national TB/HIV policies.
We need to start working on tomorrow's solutions today. It's time to do it right, to do it now and to do it together."
WHO Acting Director-General, Dr Anders Nordström, spoke of the "urgent need for TB control" in the wake of the XDR-TB threat:
"Another key element in the (HIV/AIDS) epidemic -TB - has recently drawn increased attention with the development of an extremely drug-resistant form that signals the urgent need for TB control. TB causes up to half of all deaths in people living with HIV.
The AIDS epidemic provides us with clear evidence that even some of the most complex health and development problems can be successfully addressed. To see this positive pattern repeated everywhere will take greater political will and more resources."
WHO Stop TB Director, Dr Mario Raviglione, said the fight against TB and XDR-TB was now the responsibility of a wide range of individuals and organizations:
"World AIDS Day is being marked under the spectre of a newly-identified threat to human health, the threat of a highly drug-resistant form of TB. As we have seen through research published for the first time this year, XDR-TB is having a serious and detrimental effect on communities.
Addressing HIV and TB co-infection, and also drug-resistant TB are core components of the work of the global TB community through WHO's new Stop TB Strategy. The Stop TB Strategy strengthens TB control and as a result strengthens the health, safety and protection of people living with HIV, everywhere.
Waiting to act will be immoral. We need a full range of individuals, from government officials in TB and HIV programmes to non-governmental organization staff; from financiers to communities. All of them have a role and a responsibility to build an adequate and rapid response."
UNAIDS Executive Director, Dr Peter Piot, warned that "MDR-TB and XDR-TB highlight new challenges in our collective response" to HIV/AIDS. The December 2006 UNAIDS/WHO AIDS Epidemic Update also outlines the need for specific actions:
"TB drug resistance arises mainly because of inadequate TB control, poor patient or clinician adherence to standard TB treatment regimens, poor quality drugs or inadequate drug supplies. People living with HIV are particularly vulnerable to developing drug-resistant TB because of their increased susceptiblity to infection and progression to active TB.
This outbreak (of XDR-TB) underscores the need to rapidly ensure prompt TB diagnosis and effective TB treatment for persons living with HIV in order to prevent drug resistance from developing and spreading. Access to TB culture and drug sensitivity testing must be improved, and effective infection control practices must be introduced in HIV care clinics to prevent the spread of TB."
Leading Kenyan TB/HIV advocate, Lucy Chesire said to combat XDR-TB "funding must flow readily and urgently":
"Today, people living with HIV are facing a new challenge and a new threat - the threat of a form of tuberculosis that is highly fatal. The world must not let XDR-TB out run us.
The need for greater coordination between efforts to fight TB and programmes to fight AIDS has never been stronger than right now. XDR-TB must top the agenda of the HIV community.
To combat XDR-TB, funding must flow readily and urgently, and especially in sub-Saharan African where XDR-TB has already claimed far too many precious lives. "