By Nevson Mpofu and Byron Mutingwende
This year’s March 24 World TB Day celebrated in Shurugwi paved a new way for strategies to end the disease. Ending Tuberculosis could be achieved through testing and screening, it has emerged.
The fact on ground is, in populations with high HIV prevalence, many people infected with HIV develop TB, and many TB patients are co-infected with HIV. Therefore, the Global estimation is, 60% of Tuberculosis patients are HIV positive. Clear evidence on ground is of an estimated 8, 3 million people, new cases of TB World -wide and the bigger percentage is in Developing countries. This ‘marriage’ can only end if the World unites to focus on the two by getting into both tests, counseling and total treatment adherence in the waged united battle to save the World.
Zimbabwe is lucky enough to be running the ZIMPHIA, Zimbabwe Population Based HIV Impact Assessment which is a house hold national survey in-order to measure the status of HIV national response. It also looks at counseling and testing and also the collection of information on treatment and care services. It is funded by PEPFAR and was implemented by Columbia University with partners, National Aids Council, ZIMSTAT and Bio-Medical Research and Training Institute .The link of TB/HIV is reversing treatment success stories and will contribute to failure of some Sustainable Development Goals completion by some countries mainly in the developing world.
Since the two are in marriage, there is need for multi-concerted effort, multi responses and systemic interventions to come to terms with the 90, 90, 90, 2016 targets of the United Nations which focus on HIV free generation by 2030. The targets respectively dwell on “get tested, get treatment and suppress viral load” call. Therefore, there is need to explore on new policy areas by which the World needs to strategize International protocols. Countries need to frame out policies and legislation on declaring HIV\TB a global disaster.
Global policies, responses and interventions are the only strategies and modalities to create a free HIV generation. In that global effort to eliminate HIV, the World should unite to address this once and fore all and push for everyone to go for HIV and TB testing. The Global Public Health target will automatically be won by 2030. Imagine how clean the World would be in the face of health for all targets. This could build a new World since many people in the world are not aware of their HIV/TB status. Just imagine how disturbing it is. HIV and Tuberculosis relationship continues to grow in a relationship, which needs strong divorce efforts as the two creates a negative shape to community development. This year’s commemorations held in Shurugwi in the Midlands Province showed the continuous relationship as Dr. Charles Sandy, Deputy Director, AIDS and TB, Ministry of Health and Child Care pointed out that Testing could be a solution to the challenges facing the World as far as Tuberculosis is confirmed to be in matrimonial link with HIV and AIDS.
‘’Testing everyone for Tuberculosis sounds very effective and worth every moment for countries to finally end the epidemic. We may make this big push, but however the strong alienating issue on ground is on stigma and discrimination of those who are HIV and TB positive.
‘’As long as stigma and discrimination lives, we are bound to fail, why , because some will not come to the open about their status . What we did on the TB day in terms of testing is a strong way forward since we engaged the Parliamentary portfolio committee members get TB testing. If we do it first, the next person is you ‘’
‘’Lets fight impediments to HIV and TB treatment, then we open up way as we look at best how we can apply 90 ,90, 90 targets , implement policies and foster interventions as we give strong prevention , treatment , care and support those who are in palliative care state which focuses mainly on pain management by Medical Doctors,” he said .
This year’s theme, which is “UNITE TO END TB. LEAVE NO-ONE BEHIND” could go a long way in uniting all souls of the World to move towards new behavior change and be transformed to ensure zero TB/ HIV infections, zero stigma, zero new infections.
A Health Expert on tuberculosis at the World Health Organisation in Zimbabwe, Dr. Patrick Hazangwe said if all people could unite to end TB, great strides would be achieved without failure.
‘’If we all unite, we end TB. Imagine if the World takes heed to this notion of say everyone like as you say must go for TB and HIV testing, great strides, but we have to struggle to put up on all related policies and Legislation and bring International protocols home, that would be wonderful since TB needs our attention as we track its history, causes and effects. ’He added.
Tuberculosis is Globally defined as a Communicable airborne disease, which affects the lungs .It is a bacterial infection spread through inhaling tiny droplets from the cough and sneeze of someone who is mycobacterium or tubercle bacilli infected. Mycobacterium and tubercle bacilli bacterium is the major cause of Tuberculosis. Mycobacterium is for active TB and tubercular is latent meaning, it is less effective.
Tuberculosis has been there for over a 100 years and has been treatable for the past 40 years with positive success. Its fast spread was through modernization, industrialization, urbanization population explosion, severe absolute poverty in communities and globalization.
Governments, civic society, Non-Governmental Organizations and the corporate world invested large sums of money in projects to do with proper management of HIV and AIDS in communities, work place and schools. Some of the International ones are USAID, PEPFAR, UN agencies like the World Health Organisation and the Global Fund .The funding was channeled towards Health improvements in especially developing countries like highly burdened 22 countries of the World of which Zimbabwe is on number 17.
Southern Africa is ranked high on the List of High Burdened regions of the world and needs at least US$50 million if not less for Tuberculosis programs, because in 2007 it had nearly a million new Tuberculosis cases, and an estimated Incident Rate of 5000 cases per 100,000 population, according to the Treatment Action Group.
Tuberculosis Disease is characterised mostly by bad cough, which is prolonged, coughing up blood, and weight loss, loss of appetite and chest pain, high fever and night sweating. It can also cause severe complexion change to emaciated dark skin.
Tuberculosis is spread in three ways, in the Air through breathing bacteria filled air, Saliva spread during unprotected severe cough which lasts longer or even short and when close to someone having unprotected cough and sneeze, who in this respect has Tuberculosis.
In 2006 on World Tuberculosis Day while in South Africa, Dr. Tim Francis revealed that Multi Drug Resistant and Extreme Drug Resistant Tuberculosis were resistant to TB treatment. However some countries like Zimbabwe have succeeded in treating Tuberculosis without challenges .Many countries have done well too, though the problem is still escalating in the HIV and AIDS era, there is need for adequate funding for infrastructure , TB/HIV technology and policy formulation and implementation at a Global level .
According to a Research carried out in Kwa-Zulu, Natal in South Africa in 2006, among 53 patients with XDR TB – 52 died within 25 days. Among them 40-45 people had tested HIV positive. This paved way for countries like Zimbabwe to work on various TB/HIV programmes, which have decreased its HIV prevalence rate from above 30% now at less 14%.
UNAIDS revealed that AIDS is claiming 3 million people Worldwide, TB is claiming 2 million people in a world of 7 Billion, 50 -55 million are living with HIV positively, 25-30 million have died and 22-24 million are in Sub- Saharan Africa.
Although there is an 18 percent decline since 2000, in 2014, 9, 6million people fell sick and 1, 5 million people were killed in many developing countries. In 2014, 1million out of 140 million children died from Tuberculosis .Global Alliance on Vaccines and Immunization working with Word Health Organisation and other implementing partners work on Bacilli Chalmette-Guerin [BCG] used in children to treat tuberculosis.
It is also a fact that 43 million people globally have been saved from this deadly infection. Thanks to various health interventions and policies. Governments must further put their efforts on key populations of HIV and AIDS. These are people like commercial sex workers and their male partners, men who have sex with men, multiple concurrent partners with no behavior change towards HIV and AIDS and the HIV positive who get activated in unprotected sex.
