1. VISION
I started with this and will end with it because it is important to know where we want to go. It sets the direction to take.
IF YOU DON’T KNOW WHERE YOU ARE GOING ANY ROAD WILL LEAD YOU THERE
However we know where we want to go and pick out path accordingly.

2. Patient focussed, collaborative action of TB, and HIV/AIDS programmes & general health services, varying with TB/HIV burden.
Effective use of all existing tools, and mechanisms for continuous improvement.
Global strategies to implement, and rapidly scale up, TB/HIV care and prevention.
Read out
Thank you
Input and comments most welcome.

3. Patient focussed, collaborative action,
Yes, but what sort of collaboration exactly ?
The kind that improves:
access to care and prevention for TB/HIV patients,
efficiency and quality of service delivery,
that adds synergy through:
more case finding (TB and HIV/AIDS),
and better prevention, and
that stems from a shared TB/HIV responsibility!

4. is the responsibility of programmes, supported by general health service.
What are arguments for that ?
TB and HIV/AIDS are different diseases with specific control strategies. Both need continuous improvement, based on monitoring (TB/HIV included !), and effectiveness measurements.
TB/HIV burden in SSA is enormous, but so is the TB burden without HIV/AIDS, and vice versa.

5. Effective use of all existing tools
Do we know the (cost-)effectiveness thereof ?
Not yet for all but we will.
Note that (cost-)effectiveness of DOTS itself depends on HIV-AIDS control !
PROTEST yields promising results for VCT, the heart of all TB/HIV interventions.
Time for integrated TB/HIV estimates of effectiveness (HAART, VCT, etc).

6. Mechanisms for improvement
Do we have to stimulate basic research ?
Basic research is key for better tools; imagine we could cure latent TB with one antibiotic in two weeks.
However, this is not the focus of the TB/HIV working group; others work on that.
We focus on operational research to add more years to life's, and avert more TB/HIV.

7. Global strategies to implement ...
A single strategy, or more strategies?
Both
Singular
TB/HIV is not another vertical programme.
Generic strategic framework & guidelines.
Policy paper
Multiple
Guideline aspects, phased implementation activities
Country policy plans

8. Global strategies to scale up !
What sort of global strategies will do that ?
We need to spread the news and vision that:
HIV/AIDS and TB are engaged in an extremely deadly relationship,
this dual epidemic can only be taken on by taking responsibility for a joint effort.
When this news and vision reaches those who are in control, scaling up will follow.

9. TB /HIV Working Group 3rd Meeting
First I will give you, under this heading, a summary follow up about an issue which was on the agenda of the previous meeting in Durban , but not dealt with there: Governance.

10. Meeting Outcomes By Friday afternoon we have the:
latest data on TB/HIV epidemic shared,
ongoing TB/HIV activities overviewed,
future TB/HIV activities identified,
TB/HIV policy document enriched,
operational research priorities developed,
TB/HIV partnership strengthened.
Read out
To finalise let me go back to where I was at the beginning, i.e. to the vision on which these actions and outputs are based.

11. Thanks to all TB/HIV WG Partners
The size of the partnership grows. This meeting 150 coming
Cannot read the list of this meeting to acknowledge the work of all.
Made a limited selection to be listed here
Now about the vision the facts, and the actions