TB/HIV Working Group: Achievements 2003-2004 TB/HIV Working Group Meeting, Addis Ababa, September 20-21, 2004 TB/HIV Working Group: Achievements 2003-2004 Paul Nunn on behalf of the Secretariat GLOBAL PARTNERSHIP TO STOP TB

Contents Background Outcomes of WG 2003, Montreux Achievements 2003-2004 Policy development and analytical work Country-level progress Advocacy, communications and partnership building Future directions

Background Before 2001 Since Jan 2001 Clear recognition of the problem of HIV for TB ProTEST in Malawi, S Africa and Zambia Coordinated TB/HIV activities in Côte d'Ivoire, DRC, Haiti, Thailand etc Since Jan 2001 Global Fund to fight against AIDS, TB and Malaria President's Emergency Plan for AIDS Relief WHO unit for TB/HIV Stop TB Partnership's TB/HIV Working Group

Goal of the TB/HIV Working Group To promote more effective TB/HIV care and prevention, through Development of all necessary tools Assistance to countries Advocacy and partnership building

Who is the Working Group? Countries National programmes, NGOs, Community groups Development agencies Expert individuals, activists Foundations Multilateral agencies Research institutions Technical agencies 154 members in Addis, of 225 on database Secretariat housed in WHO/Stop TB

Montreux 2003 Principles and Strategies going in Two diseases, one patient No separate TB/HIV programme Action needed urgently on collaborative TB/HIV activities in countries Working group meeting to be a forum Core group to provide strategic direction

Recommendations for Action Complete WHO policy Underpin with cost-effectiveness and behavioural analyses NTPs to implement “opt-out” HIV testing Expand partnerships especially with ARV treatment scale up, community, private sector Prioritise research agenda WG to be global in focus

TB/HIV policy guidance - 2004 Interim policy M&E Surveillance ART ProTEST lessons TBHIV Clinical HIV testing policy

Analytical work on TB/HIV Costs of delivering TB/HIV policy $200 to $300 million per year initially(Katherine Floyd et al) Cost and cost-effectiveness finding and curing active TB (Christine Currie et al AIDS 2003) ART gains more DALYs but is much more costly IPT has low costs, but low effectiveness (submitted for publication) Cost-effectiveness analyses for ProTEST in Malawi and Zambia due end 2004 (LSHTM)

Conclusions on policy & analysis Minimum essential set of policy guidance now available Supported by analytical work, but more is needed Greater emphasis on the HIV-side elements

Country level progress GFATM – TB/HIV Activities 13 countries received funds (3 in 2003) 4 signed agreements 11 approved The Emergency Plan – now 15 countries 20/22 WHO's high TB burden countries implementing, with regional strategies 31 of 41 high TB/HIV countries: 19 in 2003 had joint planning at national level Peripheral activities are not well reported Training strategy from global to national, being implemented

Country progress - summary Funding is no longer the bottleneck Many countries in early stages of planning, fewer implementing TB/HIV activities in most regions Improvement in country policy 2002-2003 Recording and reporting gap at peripheral level Implications for demonstrating progress to funding agencies and for technical assistance

Advocacy and Communications 2003-2004 - Major shift in environment Generation of demand, political and popular support and resource mobilization Enhanced patient activism and civil society involvement Increasing recognition in HIV community of TB as part of the solution OSI TB/HIV booklet Involvement of HIV advocacy groups UNAIDS, TAG, GNP+, EANASO, ICASO and in 10 countries Increasing interest in TB Community and DEWG Media material Advocacy pack (UNAIDS Communications - BMGF funding) Flash film on TB/HIV - Winstone Zulu "Kill or Cure" 25' Film on BBC World TV

Mandela urges action to fight TB By Chris Hogg BBC Bangkok BANGKOK: by Lawrence K. Altman – Nelson Mandela came to the 15th International AIDS Conference here Thursday to lend his prestige to the battles against tuberculosis and AIDS, two deadly diseases that are intricately linked. BANGKOK (Reuters) – The global war on AIDS could be lost if the world ignores tuberculosis, often a "death sentence" for people infected with HIV, former South African president Nelson Mandela said on Thursday. Mandela sounds alarm on TB "death sentence" in AIDS war By Darren Schuettler

Partnership building - The Working Group TB/HIV WG Core Group Enlarged and expanded, greater regional representation Responsible for strategic direction Productive partnerships emerging: CDC-DTBE, CDC-GAP, Country level HIV advocacy networks, CREATE, Futures Group, GFATM, GLRA, GNP+, KNCV, The Emergency Plan, TAG, UNAIDS, WHO

Future directions Will be addressed in Gijs' presentation

Your Secretariat: