Saturday, November 30, 2013

Violent love story of a sexy disease and an unsexy disease – We need to find its end, forever

WORLD AIDS DAY 2013 - message from Universal Health
Being primarily an air-borne infection TB has lost the glamour of a ‘sexy disease.’ But the naked truth is, TB is not selective as HIV and can affect anyone in the society. Unfortunately, those infected by HIV have greater chance of TB infection or active TB disease from a latent infection. The intimacy with the sexiest disease on earth makes TB more noticeable over last couple of decades. And in today’s world Drug-Resistant TB has already spread the dread across the globe the way HIV did decades back before the emergence of ART.

The fact is, the love-story between a sexy disease and an unsexy disease is still going strong. Both the diseases carry tons of stigma. While HIV looks for specific openings like unprotected penetrative sex, needle/syringe sharing and pregnancy, delivery & breast-feeding of an infected woman to trigger and maintain its transmission, TB has the potential to hit anyone, particularly those lying within the territory of poverty and marginalization with poor access to health services. 
Actually, both the diseases, most of time target the same groups of people – poor, illiterate, living in unhealthy living conditions, having limited livelihood options that often lead to migration or sex work or trafficking, injecting drugs as the last resort of poverty-struck recreation and those having no/inadequate access to services due to various reasons including those identifying them in different gender.

Once HIV manages to get the entry into the body, it makes the things easy for TB to show its sting. Similarly TB boosts up HIV in its progression to AIDS. 

Where will you find such violent and virulent loves on earth ? 

 Most of the people infected by HIV get killed by TB.

TB is an old traditional killer and it kills more when it makes love with HIV.

Ideally, all persons with known HIV positive status should have sound knowledge of TB so that they can demand and present for TB screening on slightest doubt. Ideally, rapid and new diagnostic techniques should be in place for early diagnosis of TB among HIV infected, affected and vulnerable population groups. Ideally, all the TB affected persons should be offered HIV counseling and testing services. Ideally, all the HIV-infected persons should have access to prophylactic services of INH and CPT. Ideally, all HIV-infected TB cases should be put on ART without waiting for their CD4 results.

Ideally, TB and HIV professionals, TB and HIV program managers, TB and HIV healthcare providers, and TB and HIV policy makers should have free, frequent and unprejudiced interactions at all levels, national, province, district and sub-district.

Ideally, whenever there is a talk/discussion/debate/seminar/conference/workshop/exhibition on HIV, TB should be the integral part of that and vice versa.

How much we have internalized these ideal conditions which mostly exist in the documents? How much we are geared up to create those ideal conditions? How strong is our partnership to make those ideal conditions happen in reality?

After all ‘ZERO HIV DEATH’ without stopping TB sounds like a fantasy.

Let’s no more fantasize and get into some real action to disrupt and terminate the violent love-story of a sexy disease and an  unsexy disease, forever.

The time is right here.

Sugata Mukhopadhyay
Universal Health

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