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HIV complicates Africa's 'super TB' threat: WHO

Anteroposterior X-ray, shows advanced bilateral pulmonary TB ~ Wikipedia

Seen are the presence of bilateral pulmonary infiltrate (white marks) and caving formation (black)

October 18, 2006, 07:15

Highly drug-resistant tuberculosis could become a major killer in Aids-hit parts of Africa where governments have been slow to roll out TB control programmes, the World Health Organisation (WHO) said yesterday.

Urgent efforts are under way to redirect donor funds to fight virulent strains of TB, known as extremely drug resistant or XDR-TB, after an outbreak in South Africa that has killed at least 74 people since January 2005.

Most of those cases were among HIV-positive people whose immune systems were already weakened by the Aids virus. "The XDR-TB crisis will not in most parts of the world be solved unless HIV is properly considered. We have for now been paying lip service," Teguest Guerma, of the HIV department of WHO, told health officials at a TB workshop in Johannesburg.

"Underlying HIV will add significant challenges to the clinical response." Tuberculosis is the leading killer of Aids patients and both diseases are on the rise in southern Africa. Tuberculosis could have a disastrous impact in sub-Saharan Africa - the hardest hit region in the global Aids epidemic - which has a poor health infrastructure.

Overlapping strategies may hold key to eradication
The best way to fight the dual problems of HIV/Aids and TB is to overlap strategies to combat them, said experts. A big hurdle is that no new medical antibiotics for TB have been developed in four decades and it will be at least 2020 before new treatments are widely available. It could also be difficult to attract new funds as the $4.7 billion required by the Global Plan to Stop TB each year consistently comes up short, said officials.

However, representatives from the Global Fund to Fight Aids, Tuberculosis and Malaria have agreed to shift existing funds to combat XDR-TB and the US-backed PEPFAR is considering a similar request, said Paul Nunn of the WHO.

Government representatives from Swaziland, Lesotho, Namibia, Malawi, Zimbabwe, Mauritius, and Mozambique, and WHO officials and scientists were invited to attend the two-day workshop by Manto Tshabalala-Msimang, the South African health minister. The minister was unable to attend because she is in hospital being treated for what is being described as a lung disease. – Reuters

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