Tuberculosis, HIV: A deadly ‘marriage’

However, when the journalists were asked whether they would as eagerly take an Aids test there were groans and moans. Everyone loudly expressed unwillingness to have an Aids check. But ironically the lung destroying infectious tuberculosis (TB) and HIV/AIDS are now such a deadly combination that their “marriage” has sparked new complex problems in the fight against the ravaging HIV and AIDS.
“The 100-year old TB is now married to the young HIV and the honeymoon is causing a lot of death and misery,” said Chigodora while presenting a paper titled “Tuberculosis and HIV — a deadly ‘marriage’.”
United Nations Aids (UNAIDS) says when HIV weakens a person’s immune system this creates greater susceptibility to TB infection and the disease is very difficult to diagnose and more complicated to treat in people who are HIV positive.
And despite the fact that TB and HIV and AIDS are now the major killers in Zimbabwe and Africa many people on the continent are unaware of their TB or HIV/AIDS  status until they fall sick, further complicating an already deadly situation. It is estimated that at least two billion people are infected with TB worldwide, accounting for a third of the global population. Two million of those infected die every year from the disease that has become a serious public health problem.
The TB bacterium is spread through droplets in the air when an infected person coughs, sneezes or talks and exposure to someone with untreated TB increases the chances of infection.
Seventy percent of the global TB and HIV and AIDS co-infections are in sub-Saharan Africa with Zimbabwe ranking 20th among countries in this category.
Tim France, a medical doctor attached to the Thailand-based Health and Development organisation says: “The point, however, is not to tally up marks for a macabre competition; it is precisely the opposite: We need to stop thinking of the two diseases in separate bodies, because a third of the 40 million people living with HIV today are also co-infected with TB.
“The solution is absurdly simple: Break down the walls of established thought between the two diseases and you hold the biggest promise for saving millions of lives.”
France pointed out that although “the two worst global health problems have combined forces well” the institutions addressing them have not. While annual spending on HIV programmes increased 16-fold from US$500 million to around US$ 8 billion per year during the first five years of this millennium only a paltry 70 percent increase in funding for anti-TB efforts was recorded during the same period.
“Crucially, people with HIV are about 30 times more likely to develop active TB than those without HIV, fuelling a resurgence of TB in sub-Saharan Africa and some states of the former Soviet Union. East and South Asian countries face the same threat.
“Imagine the two diseases in one body. Jolting enough to be told you have TB, then to be called back to hear your HIV test was also positive.
“The doctor is fully aware that TB progresses faster in HIV-infected people, and that TB in those who have HIV is more likely to be fatal. Their task now is to explain to you that the two diseases often cannot be treated at the same time; the two sets of drugs can interfere with one another,” says France in an article titled: “The chasm between HIV and TB”.
Despite this glaring reality, the paradox in perceptions on the two diseases persist and is perplexing.
While HIV and Aids have been highly profiled by everyone including politicians TB advocacy is entirely in the opposite sphere. It is as if the disease is of little consequence, largely because it is curable, treatable and preventable while HIV and Aids is incurable but manageable.
But breaking the entrenched attitudes has proved difficult, with the responsibility to re-shape public thinking and shift opinion on the serious problems confronting the global fight against these major killer diseases now lying with the media.
“With the emergence of the multi-drug and extreme-drug resistant strains of TB, both of which are far more challenging to treat than conventional TB — the mandate for the media to advocate greater awareness of the linkages between TB and HIV is even more pronounced,” says SAFAIDS. According to the World Health Organisation people living with HIV have been, for instance shown to be twice as likely to have multi-drug resistant tuberculosis (MDR-TB) than uninfected people.
Urging the media to take up a leading role in highlighting the serious challenges brought about by TB and HIV combination, Chigodora said: “It’s time to transfer HIV advocacy skills to TB advocacy to disrupt the HIV/TB honeymoon. TB is everybody’s problem, so let’s fight the disease through information.”