AIDS and Rights Alliance for Southern Africa, Médecins Sans Frontières, Open Society Institute, Partners in Health, and Treatment Action Campaign organized a satellite meeting during the 38th World Conference on Lung Health to highlight the challenges of diagnosing and treating drug-resistant tuberculosis in southern Africa and other regions with high HIV rates. The satellite underlined the urgent imperative to explore novel approaches in such settings.
Tuberculosis is the leading cause of death among people with HIV/AIDS in sub-Saharan Africa. The World Health Organization estimates that up to 80 percent of TB patients are living with HIV in the region. However, with today’s limited diagnostic tools and lack of laboratory capacity in many rural settings, smear-negative TB, extra-pulmonary TB (common in people living with HIV) and drug-resistant TB are difficult to detect.
Treatment for drug-resistant TB is not widely available in most parts of southern Africa. Where treatment exists, it is usually centralized and facility-based. This approach contributes to long waiting lists and poses constraints for patients and their families.
Experience in fighting drug-resistant TB to date comes mainly from Eastern Europe and South America, but the situation is radically different in southern Africa, forcing governmental and non-governmental agencies to think outside-the-box about where and how to manage diagnosis and treatment of drug-resistant TB, infection control, and treatment adherence.
At the Time for Change satellite, representatives of the WHO, national TB programs, field-based medical NGOs, and activists discussed the merits and challenges of decentralized, community-based drug-resistant TB management in southern Africa.
Key Questions
- What are the limitations and risks of hospital-based drug-resistant TB treatment in settings with limited resources and high HIV infection rates?
- What new treatment approaches could be implemented given the limitations of current tools?
- What is the most appropriate treatment regimen in a region where second-line drugs are largely used and extensively drug-resistant TB (XDR-TB) is already prevalent?
- How can access to culture and drug susceptibility testing be increased in the region?
- What would be the most appropriate case-finding strategy for early detection of drug-resistant TB in a context of high HIV and drug-resistant TB prevalence?
- What lessons for TB treatment can we learn from patient-centred approaches to HIV/AIDS treatment?
- How can community health workers and activists contribute to improving diagnosis of drug-resistant TB and adherence to treatment?
- How can governments, NGOs, and activists effectively push for research and development of new diagnostic and therapeutic tools?
- How can advocacy efforts ensure that patients benefit from the best possible quality of care according to today’s available tools and knowledge?
- What national, regional, and international policy opportunities and struggles lie ahead?
Agenda & Participants
Download copies of the complete agenda and participants' bios below.
Media Contacts
Paul Silva, OSI
psilva@sorosny.org
Alessandra Vilasboas, Médecins Sans Frontières
alessandra.vilasboas@joburg.msf.org