Saturday, November 30, 2013

HIV community groups & networks demanding for high quality TB services – let the dream come true

WORLD AIDS DAY 2013 - Experiences of Universal Health

In the recent International Congress of AIDS of Asia-Pacific/ICAAP in Bangkok I couldn't find traces of concern around HIV-associated TB deaths except few ad-hoc basis discussions on HIV related co-morbidities with TB being a small component. The speakers and participants across the Congress spoke volumes on rights, stigma, discrimination, legal issues, access and mobilization but kept mostly quiet on the burning TB/HIV issues of the Asia-Pacific regions.

The statistics of South-East Asia[1] say, every year more than 50,000 people die due to HIV-associated TB, less than 40% TB cases know their HIV status, less than 40% PLHIV get screened for TB and access of PLHIV to INH prophylaxis is more than negligible.

Demand for newer diagnostics for rapid diagnosis of TB/DR-TB was not heard in the voices of community networks who otherwise made their presence strongly felt across ICAAP.

A prominent member of Asia-Pacific TG network told me, ‘The problem of TB lies in your overall poor advocacy.’

A known friend of the PLHIV network of an Indian state commented, ‘I am really not bothered much about HIV now, but TB scares me hell of a lot, almost every time.’
‘Why don’t you discuss about TB within your group?’ I asked her.
‘I really don’t know what to say except cough for more than 2 weeks.’ She replied pessimistically.

The ICAAP experience made of aware of the fact that we are failing miserably to sensitize people, providers and policy makers on TB and its implications in the background of HIV. It is a grave problem and we must find the solutions.

Limited sphere of advocacy where the advocates don’t really want to venture out of their comfort zone is a big issue in TB. As far as international conferences are concerned the advocacy efforts, in true sense are yet to cross the boundaries of the World Lung Conferences.

Working with HIV community networks might be highly challenging to many TB professionals and advocates, but the fact is 'need for appropriate TB care' is maximum with those networks. When mobilization is their operational expertise these networks need proper guidance to know the right path for consolidating their mobilization and demand generation activities on TB. That’s exactly where we are repeatedly failing to produce any impact.

It is important to bring TB in the agenda and action plans of the international, regional, national and local level HIV community networks (Sex Workers, IDUs, MSM, TG and PLHIV). Let community people speak freely and firmly about their TB problems together with HIV and demand for health facilities enabling rapid TB diagnosis and early treatment. Let there be stronger demand from the community groups for ready access to 3 Is (Intensified TB screening, INH prophylaxis and Infection Control), ART for all HIV-infected TB patients and combined screening of the pregnant mothers for TB and HIV.

TB/HIV collaboration in its true sense can only happen when HIV community groups and networks will play their advocacy cards of TB and HIV on the same table to ensure the right placement of the right package of services for them.

This is the high time we, the not-so-visible TB advocates in the AIDS Conferences, facilitate the process, with utmost sincerity and dedication.

Sugata Mukhopadhyay
Universal Health

[1] Global TB Report 2013

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