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

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

3. 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

4. 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

5. 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

6. 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

7. 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

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

9. 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)

10. 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

11. 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

12. 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
Recording and reporting gap at peripheral level
Implications for demonstrating progress to funding agencies and for technical assistance

13. Advocacy and Communications
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

14. 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

15. 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

16. Future directions
Will be addressed in Gijs' presentation

17. Your Secretariat: