The first HIV-TB Global Leaders' Forum was held at the United Nations on Monday June 9, 2008, marking the first time world leaders, senior political officials, activists, and global health experts have gathered to specifically address the dual threat of HIV and TB, two of the world's deadliest and most intertwined infectious diseases.
Participants emphasized the need for accelerated scale-up of collaborative activities to control HIV and TB as the number of people infected with both diseases, or at risk of developing both, is rising worldwide.
Former President of Portugal Jorge Sampaio, who is the UN Secretary-General's Special Envoy to Stop TB, said "strong political leadership" is necessary to respond to the growing threat of HIV and TB.
"If we succeed in responding to HIV and TB together, this would be a pathfinder to strengthening health systems," Sampaio said. He added that new medical tools are "badly needed" as part of a combined response.
When a person is infected with either HIV or the bacterium that causes TB, the risk of developing the other disease significantly increases. It is difficult to treat people co-infected with HIV and TB because today's lengthy anti-TB drug regimen is not compatible with some common HIV treatments, meaning patients must often delay life-saving HIV therapy for months.
The outcome of Monday's meeting was a Call to Action addressed to delegates from UN member states who also met this week in New York for the review meeting of the UN General Assembly Special Session (UNGASS) on HIV/AIDS. Among the issues raised in the Call to Action is the urgent need for new and better TB drugs, diagnostics and vaccines -- particularly for people living with HIV/AIDS -- and the recognition of HIV and TB as formidable constraints to socioeconomic development.
Director General of the World Health Organization Dr. Margaret Chan told participants the development of new technology to fight TB is critical. "We must urgently address the need for better tools through enhanced investments in research and development," she said.
Chan also warned that the emergence of drug-resistant strains of TB is further limiting treatment options for people with HIV and TB.
One third of people living with HIV also harbor the bacterium that causes TB, and those who are HIV positive are up to fifty times more likely to develop TB. Despite being curable, TB is a leading cause of mortality among those who are HIV positive. Additionally, drug-drug interactions between the current first-line TB regimen and certain commonly used Antiretroviral (ARV) therapies complicate treatment for co-infected patients. The emergence of multidrug-resistant TB and extensively drug-resistant TB (MDR-TB and XDR-TB) further complicate the challenge of delivering effective treatments.
The world has become increasingly aware of the economic burden HIV and TB can place on medical systems and people during their most productive years. An integrated approach to treating these two diseases is imperative to reach the Millennium Development Goal of halting the rise of HIV/TB and TB by 2015.
The Forum opened with remarks from UN Secretary General Ban Ki Moon, Jorge Sampaio, former U.S. President Bill Clinton, and UN General Assembly President Srgjan Kerim. The panel that followed focused on strategies to address the dual threat of TB and HIV, while a second panel centered on the opportunities to harmonize programs.
Statements were also delivered by representatives of UN member states. Delegates shared success stories of efforts to harmonize HIV and TB programs and concerns about the resources needed to implement such strategies. They also expressed or reaffirmed their nations' commitments to improve access to treatments and better coordinate control efforts. Moderated discussion and input from representatives of participating organizations followed each panel.
Progress toward the integration of treatments for HIV and TB will be reported on regularly during future UNGASS meetings and other high level meetings on HIV/AIDS, health and development convened by the United Nations system. The Stop TB Partnership Partner's Forum, to be held March 2009 in Rio de Janeiro, Brazil, marks another opportunity to share advances in the coordination of HIV- and TB-related initiatives.