Major boost for TB/HIV integration as Global Fund mandates unified funding applications

30 October 2013 - Geneva - In a major step forward for people affected by tuberculosis (TB) and HIV co-infection, the Global Fund to Fight AIDS, Tuberculosis and Malaria has made a bold change to the way it approaches treatment programmes in countries with high rates of both diseases.

The strategy committee of the Board of the Global Fund has decided that, in future, any country with high rates of TB and HIV co-infection that applies for funding for treatment programmes will have to design its programmes in a single unified application for joint TB and HIV programmes, rather than submit separate proposals for each disease. The new requirement is designed to streamline programming for countries heavily burdened by the two diseases.

"This is a huge leap forward," said Lucica Ditiu, Executive Secretary of the Stop TB Partnership. "We have known for some time that if we can scale up collaborative activities, TB needn’t be a death sentence for millions of people living with HIV. This decision takes us from knowledge to action."

The Global Fund has encouraged joint TB and HIV proposals in recent years, with limited success. Under the Global Fund’s new funding model, scheduled to begin full implementation in March 2014, all countries will adopt a new funding application approach, and proposals will need to have integrated and joint programming for the two diseases wherever co-infection is high.

"By integrating HIV and TB from the beginning we will ultimately make it easier for people to not only access HIV and TB testing but also life-saving treatment," said Luiz Loures, Deputy Executive Director of Programmes at UNAIDS. In collaboration with its partners, the Global Fund will work with countries to help them develop applications for approval by the Board.

"The two diseases are closely related, in many cases one patient comes to a treatment facility with the two diseases," said Eliud Wandwalo, Senior Disease Coordinator for TB at the Global Fund. "The combined application process will have many benefits to countries in programming to fight the two diseases." People living with HIV are much more likely to develop TB disease than those who are HIV-negative. TB is also a big killer for people living with HIV. In the Global Tuberculosis Report 2013, the World Health Organization says that in 2012, 1.3 million people died from TB. Of those deaths, 320 000 were among people living with HIV.

The highest rates of TB and HIV co-infection are in Africa, where 43 percent of TB patients had a positive HIV test result in 2012. A scientific model, produced by the Stop TB Partnership and WHO and UNAIDS, shows how the world could prevent a million TB deaths among people living with HIV by 2015 by implementing simple strategies, such as screening more people for TB and getting them the treatment that they need.

"If we care about the health of a person, it is important to recognize the fact that in many places, in particular sub-Saharan Africa, TB and HIV are the same disease," said Dr Mark Dybul, Executive Director of the Global Fund.