As a tuberculosis (TB) advocate attending the International AIDS Conference, I am used to TB seeming quite extraneous to the burning issues that animate most activists, leaders and the media attending the meetings. Despite being responsible for 1 in 3 AIDS-related deaths, few AIDS organizations discuss TB, and it is easy to get discouraged.
Yet, I came away from the recently concluded International AIDS Conference in Durban, South Africa, with a much greater sense of optimism. The week started off with a well-attended TB pre-conference, including very frank and direct speeches from Stephen Lewis of AIDS Free World, one of the world’s most eloquent voices on global health and human rights, and Jose Luis Castro, the executive director of the Union.
We heard about some impressive successes in TB-HIV integration in Africa by the likes of Humana, Management Sciences for Health, TB/HIV Care Association, and others. We learned of striking research showing that, by utilizing community health workers, it is possible to increase the average number of TB cases diagnosed nineteen fold among people living with HIV. We also learned more about how TB is spread and the enormous risk of TB infection that has been documented in South African high schools.
Then, in the main conference, AIDS 2016, TB was raised in the Global Village TB-HIV Networking Zone and in nearly every full plenary. Influential activists like Nkhensani Mavasa, chairperson of the Treatment Action Campaign (TAC), decried the lack of investment in TB research, and Mark Heywood of Section 27 told a group of leading activists from around the world that the AIDS movement had not done enough on TB. Dr. Anton Pozniak, director of HIV services at Chelsea and Westminster Hospital, told a full plenary session that more aggressive action against TB was essential.
My renewed optimism is also due to a sense of greater political momentum. Political representatives from nearly twenty African countries came together to formally launch an African TB Caucus. The South African Minister of Health, Dr. Aaron Motsoaledi, doggedly championed the issue of TB and TB-HIV at AIDS 2016, reminding everyone about the urgency of the issue at the end of an inspiring street march. He also insisted on action on TB during the closing session, while also using the week to engage religious leaders the fight against TB.
Stephen Lewis, speaking at ACTION’s event to launch new research on TB-HIV policies, From Policy to Practice, declared “this conference can be the turning point” on TB-HIV. He explained the pendulum is swinging to a recognition that “we have to deal simultaneously with TB and HIV, or else we will never defeat AIDS.” He said, “You’re not going to be as alone and isolated as you have felt yourselves to be [while advocating on TB and TB-HIV].”
It is time for TB to be incorporated into the work plans of AIDS organizations in order to help push for integration and research. Rosemary Mburu, executive director of WACI Health, was interviewed by The Body, and in a press conference she stated, “We are looking for much more leadership from the AIDS community, the AIDS leadership, to take up TB integration.” Mburu continued, “We have seen more of that leadership from the TB community. We are here to see the level of leadership we need to see from the AIDS community.”
The AIDS movement is facing some of the biggest challenges it has ever faced, including a crisis on financing for HIV programs, yet by taking up the call to better integrate TB and to support TB research, we can save more lives. Following this year’s International AIDS Conference, I am hopeful that, with solidarity, we can defeat TB and HIV together.