Expanding TB/HIV Collaborative Activities
The fourth objective aims at strengthening implementation of TB/HIV collaborative activities. The Region, having been relatively spared by the HIV epidemic, has so far been characterized by rather limited implementation of TB/HIV collaborative activities. In most of the countries, TB and HIV/AIDS programmes are vertical in structure, with limited cross-cutting activities.
To scale up the response, WHO Regional Office for the Western Pacific published a Revised Framework to Address TB-HIV co-infection in the Western Pacific Region (2008). The aims of the revised framework are to:
- Conduct TB/HIV surveillance as appropriate in the epidemiological context;
- Diagnose HIV and TB as early as possible through early HIV testing of TB patients and TB screening of people living with HIV (see TB Screening Algorithm);
- Ensure that people with both TB and HIV have early access to life-saving treatment;
- Improve infection control at TB and HIV care facilities; and
- To prevent new cases of TB and HIV.
Except for a few countries, implementation of the “globally recommended collaborative TB/HIV activities” has been limited so far. Available evidence in the Region shows high mortality among TB-HIV co-infected patients, indicating late case detection of TB and HIV, and inadequate provision of life-saving interventions such as HIV testing, CPT and ART among TB patients, and TB screening and isoniazid preventive therapy (IPT) among people living with HIV. Although countries in the Region are facing very different and dynamic HIV/AIDS epidemics, TB/HIV collaborative activities must be strengthened in all the countries.