Posted March 25th, 2015 at 4:26 pm (UTC-5)
A doctor points to an x-ray showing a pair of lungs infected with TB (tuberculosis) in Ladbroke Grove in London, England, Jan. 27, 2014.
By Deborah L. Birx, M.D., U.S. Global AIDS Coordinator and U.S. Representative for Global Health Diplomacy.
This piece originally appeared on the State Department’s DipNote blog.
Each year, PEPFAR, which stands for The President’s Emergency Plan for AIDS Relief marks World Tuberculosis Day. But for PEPFAR staffers, this is not a one day effort, and this year’s theme — “Reach the 3 Million: Reach, Treat, Cure Everyone” — represents a major principle that will help focus our collective effort around the world. In too many settings, tuberculosis (TB) is still the leading cause of death for people living with HIV/AIDS. PEPFAR’s activities are focused on the area of HIV-associated TB and our effort to reach people and treat HIV and TB will continue in 2015 and beyond.
We recognize that TB, an airborne infectious disease, is a major problem for people living with HIV/AIDS, their families, and their communities. We know that globally nearly 2 billion people are estimated to be infected with latent TB, many of whom are also living with HIV/AIDS. These are people who are not sick, but have the potential to become sick from this deadly bacteria. In 2013, of the 2 billion living with latent TB, there were around 9 million people who developed TB and 1.5 million died (360,000 were also living with HIV/AIDS). The majority of these deaths are preventable since TB is curable regardless of an individual’s HIV status.
We also recognize that HIV is the strongest known risk factor for TB and that in some settings people living with HIV/AIDS have 37 times the risk of TB when compared with those not living with TB. The good news is that TB in people living with HIV is over 90 percent preventable if we use the tools that we have to prevent HIV-associated TB-treatment for HIV and isoniazid preventive treatment (IPT), a medicine that prevents TB from developing. A study by the World Health Organization found that early HIV treatment alone reduces the risk of developing TB by 65 percent in people living with HIV/AIDS. People diagnosed with HIV and TB before they are on HIV treatment represents a missed public health opportunity.
Released on World AIDS Day 2014, “PEPFAR 3.0 – Controlling the Epidemic: Delivering on the Promise of an AIDS-free Generation” summarizes the program’s strategy for working with partners to achieve epidemic control, documents PEPFAR’s progress, and unveils how we are shifting the way we do business moving forward to maximize our collective impact on the epidemic. This strategy has already spurred progress in 2014 and laid the foundation for results in 2015. Part of this strategy is a renewed commitment to addressing HIV-associated TB through the Joint United Nations Programme on HIV/AIDS’ 90-90-90 targets (by 2020, 90 percent of all people living with HIV know their HIV status, 90 percent of all people with diagnosed HIV infection receive sustained antiretroviral treatment, and 90 percent of all people receiving antiretroviral treatment are virally suppressed). PEPFAR supports access to HIV testing, earlier HIV diagnosis and treatment, TB screening, IPT, and infection control — these interventions to prevent TB illness, deaths, and transmission. This is critical since in many settings around half of people living with HIV/AIDS still do not know their HIV status and around a one-third of TB cases are undiagnosed. To address this, through PEPFAR and the work of our partners, millions of people are screened for HIV and TB.
Through our focus on delivering the right interventions, in the right places, at the right time, we are improving access to early HIV diagnosis. PEPFAR is working to achieve the 90-90-90 targets in high-burden areas and access to HIV testing is the critical gateway to achieving those targets. When people know that they have HIV they can make life-saving decisions for themselves and their families, which can also have major benefits for their entire community. They can have the option to start HIV treatment to prevent HIV and TB illness, transmission, and death. They can also ask their providers about when they can start IPT. In most places, people living with HIV/AIDS who have TB are eligible to start HIV treatment immediately — which has direct impact on the second and third 90-90-90 targets. Treating HIV and TB improves a person’s immune system and makes viral suppression more likely, addressing the third 90-90-90 target. Keeping people healthy and free from TB is an important global public health objective and PEPFAR’s HIV-associated TB work makes a critical contribution to this effort. It also has a significant impact on HIV and TB transmission, becoming an important part of the solution to this terrible HIV and TB co-epidemic.
PEPFAR strongly supports this year’s theme “Reach the 3 Million: Reach, Treat, Cure Everyone.” We will continue to: 1) prioritize TB/HIV funding; 2) work with partners to reach people living with HIV/AIDS and TB; and 3) implement our new strategy which will help alleviate the suffering of millions of people living with HIV/AIDS and TB.
World Tuberculosis Day: Reach, Treat, Cure Everyone
A doctor points to an x-ray showing a pair of lungs infected with TB (tuberculosis) in Ladbroke Grove in London, England, Jan. 27, 2014.
By Deborah L. Birx, M.D., U.S. Global AIDS Coordinator and U.S. Representative for Global Health Diplomacy.
This piece originally appeared on the State Department’s DipNote blog.
Each year, PEPFAR, which stands for The President’s Emergency Plan for AIDS Relief marks World Tuberculosis Day. But for PEPFAR staffers, this is not a one day effort, and this year’s theme — “Reach the 3 Million: Reach, Treat, Cure Everyone” — represents a major principle that will help focus our collective effort around the world. In too many settings, tuberculosis (TB) is still the leading cause of death for people living with HIV/AIDS. PEPFAR’s activities are focused on the area of HIV-associated TB and our effort to reach people and treat HIV and TB will continue in 2015 and beyond.
We recognize that TB, an airborne infectious disease, is a major problem for people living with HIV/AIDS, their families, and their communities. We know that globally nearly 2 billion people are estimated to be infected with latent TB, many of whom are also living with HIV/AIDS. These are people who are not sick, but have the potential to become sick from this deadly bacteria. In 2013, of the 2 billion living with latent TB, there were around 9 million people who developed TB and 1.5 million died (360,000 were also living with HIV/AIDS). The majority of these deaths are preventable since TB is curable regardless of an individual’s HIV status.
We also recognize that HIV is the strongest known risk factor for TB and that in some settings people living with HIV/AIDS have 37 times the risk of TB when compared with those not living with TB. The good news is that TB in people living with HIV is over 90 percent preventable if we use the tools that we have to prevent HIV-associated TB-treatment for HIV and isoniazid preventive treatment (IPT), a medicine that prevents TB from developing. A study by the World Health Organization found that early HIV treatment alone reduces the risk of developing TB by 65 percent in people living with HIV/AIDS. People diagnosed with HIV and TB before they are on HIV treatment represents a missed public health opportunity.
Released on World AIDS Day 2014, “PEPFAR 3.0 – Controlling the Epidemic: Delivering on the Promise of an AIDS-free Generation” summarizes the program’s strategy for working with partners to achieve epidemic control, documents PEPFAR’s progress, and unveils how we are shifting the way we do business moving forward to maximize our collective impact on the epidemic. This strategy has already spurred progress in 2014 and laid the foundation for results in 2015. Part of this strategy is a renewed commitment to addressing HIV-associated TB through the Joint United Nations Programme on HIV/AIDS’ 90-90-90 targets (by 2020, 90 percent of all people living with HIV know their HIV status, 90 percent of all people with diagnosed HIV infection receive sustained antiretroviral treatment, and 90 percent of all people receiving antiretroviral treatment are virally suppressed). PEPFAR supports access to HIV testing, earlier HIV diagnosis and treatment, TB screening, IPT, and infection control — these interventions to prevent TB illness, deaths, and transmission. This is critical since in many settings around half of people living with HIV/AIDS still do not know their HIV status and around a one-third of TB cases are undiagnosed. To address this, through PEPFAR and the work of our partners, millions of people are screened for HIV and TB.
Through our focus on delivering the right interventions, in the right places, at the right time, we are improving access to early HIV diagnosis. PEPFAR is working to achieve the 90-90-90 targets in high-burden areas and access to HIV testing is the critical gateway to achieving those targets. When people know that they have HIV they can make life-saving decisions for themselves and their families, which can also have major benefits for their entire community. They can have the option to start HIV treatment to prevent HIV and TB illness, transmission, and death. They can also ask their providers about when they can start IPT. In most places, people living with HIV/AIDS who have TB are eligible to start HIV treatment immediately — which has direct impact on the second and third 90-90-90 targets. Treating HIV and TB improves a person’s immune system and makes viral suppression more likely, addressing the third 90-90-90 target. Keeping people healthy and free from TB is an important global public health objective and PEPFAR’s HIV-associated TB work makes a critical contribution to this effort. It also has a significant impact on HIV and TB transmission, becoming an important part of the solution to this terrible HIV and TB co-epidemic.
PEPFAR strongly supports this year’s theme “Reach the 3 Million: Reach, Treat, Cure Everyone.” We will continue to: 1) prioritize TB/HIV funding; 2) work with partners to reach people living with HIV/AIDS and TB; and 3) implement our new strategy which will help alleviate the suffering of millions of people living with HIV/AIDS and TB.