TB/HIV epidemic in the Western Cape Update 23 February 2010 Nathea Nicolay Programme Director: Health

“When you want to go fast, you walk alone When you want to go far, you walk together” (African proverb)

HIV, AIDS and TB on the continent Estimated HIV(2010) Actual TB(2007) Deaths per day HIV infections per day People living with HIV/TB 5.8 million Total deaths Total new HIV infections Total in need of ART 1.3 million Total on treatment – Source: UNAIDS; Nathea Nicolay from ASSA2003(Provincial) AIDS and Demographic model Global TB Report 2009, WHO; Mortality and causes of death in SA 2007: Findings of death notifications, Stats SA 12.8% of all causes of death in 2007 due to TB – number 1 cause of death in SA

TB distribution Source: Global Tuberculosis Control, WHO Report 2009

HIV Infections and AIDS Deaths Source: Nathea Nicolay from ASSA2003(Full) AIDS and Demographic model

New HIV infections (Incidence) Source: Nathea Nicolay from ASSA2003(Provincial) AIDS and Demographic model

HIV Staging Source: Nathea Nicolay from ASSA2003(Full) AIDS and Demographic model

The Problem: SA Health Care Needs Sources: 1.Nathea Nicolay from ASSA2003 (Full) AIDS and demographic model 2.Shisana O, Rehle T, Harrison S, Bhana R, Ntuli A, editors: Statistics South Africa, 2005: Pretoria. HIV, AIDS and TB epidemics: 5.8 million HIV positive people (1) = biggest HIV epidemic in the world TB = leading cause of AIDS related deaths in SA HIV prevalence rates: stabilized at 11% (total pop) (2) HIV pos women 25 – 29: 33%; HIV pos men 30 – 35: 26% (2) Unequal distribution of health care resources: 85% of SA accessing only 40% of total health care spent (public health); 15% of SA accessing 60% of health care spent (3) Mortality and life expectancy: Male death rates: increased by 180% from 1997 to 2004 Female death rates: increased by 240% from 1997 to 2004 (4)

Multi drug resistant TB – MDR TB WC relatively low rates of MDR TB vs other provinces 1% of TB patients have MDR TB People who are diagnosed with TB after having been treated for TB before, 4% will have MDR TB. WHO ranks South Africa the 9th country in the world who notifies the most number of TB cases every year. On average between 450 and 600 new cases of MDR TB are diagnosed in the Western Cape annually. HIV pos person more susceptible to TB (not necessarily MDR TB) Source:

Nathea Nicolay