Global focus on HIV/TB link

By Miriam Falco
CNN Medical Managing Editor

You may not know it, but the first-ever high level meeting on HIV/AIDS and tuberculosis is underway at the United Nations right now. The former president of Portugal and UN Secretary General's Special Envoy to Stop TB, Dr. Jorge Sampaio, told reporters yesterday that the "meeting was convened to draw the attention of the world to a much neglected topic" – how TB is affecting HIV/AIDS patients and vice versa.

People living with HIV/AIDS cannot be cured, but they can live longer, with the help of antiretroviral drugs. Thanks to generous donations from the Global Fund,  UNAIDS, the Bill and Melinda Gates Foundation and the U.S. PEPFAR plan – the President's Emergency Plan for AIDS Relief, even people in the poorest countries are gaining access to these life-saving drugs.

The Global Fund even documented some intriguing stories of people being pulled from the brink of death by taking anti-retroviral drugs in a collection of photographs taken by some of the world's best photographers. These pictures and stories go on display at the Mellon Library in Washington DC tomorrow, June 11th.  You can see a special preview here.

However, too many HIV/AIDS patients aren't living long enough to reap the benefits of antiretrovirals because they've dying of TB first. The World Health Organization says an estimated one third of people living with HIV or AIDS also are infected with TB. If you're one of those people, you're up to 50 times more likely to develop TB than non-HIV infected people and the WHO says TB kills up to half of all AIDS patients worldwide.

The statistics for TB around the world are quite startling. According to the latest figures from the CDC, approxiamately 2 billion people, or one third of the worlds population carry the bacteria that causes tuberculosis - that doesn't mean they have active TB, but they could develop it.

The WHO says "HIV is the most potent risk factor for converting latent TB into active TB, while TB bacteria accelerates the progress of AIDS infection in the patient." Dr. Jim Reichman from the New Jersey Medical School Global Tuberculosis Institute puts it another way: "TB accelerates AIDS and AIDS accelerates TB."

The CDC also says 16 percent of TB cases among 25-44 year-olds in the United States in 2005 were occuring in HIV infected people.

So you may not have HIV or AIDS or TB for that matter and may not live in a poor country with fewer resources to control these diseases. But, as we all learned a year ago in the Andrew Speaker case, we may be just a vacation away or a a plane trip away from coming in contact with someone carrying TB. Speaker, you may recall, is the Atlanta lawyer who contracted TB while traveling in Asia and later flew to and from Europe, knowing he had multi-drug resistant tuberculosis.

“TB is preventable and curable and it's been so for decades" says Dr. Reichmann. This is why health officials are trying to convince the global leaders gathering at the U.N. today, to encourage countries around the world to invest more in TB prevention and treatment. To paraphrase many TB & AIDS experts, to control TB anywhere, you have to control it everywhere. But so far there's no big celebrity sponsored campaign to raise a lot of money for eradicating TB. That's why Dr. Marcos Espinal, Executive Secretary of the Stop TB Partnership told reporters yesterday, "what's highly needed is a global plan for TB and that countries embrace the plan" in order to stop the spread of HIV and TB.

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