11 May 2011 - Johannesburg - Tuberculosis (TB) and HIV co-infection in South Africa has risen up the agenda to the extent that the national AIDS council (SANAC) is considering incorporating TB in its name.
In an interview with Khopotso Bodibe from the health-e news service, SANAC's chief executive Dr Simelela said that there have been proposals to call the organization the South African Council on HIV and Tuberculosis. "I really believe that this is the route that we need to take," she said. "Our belief is that South Africa should consider itself having a TB-HIV epidemic instead of just AIDS because I think AIDS is something we are managing.
"We’re getting more and more people on treatment [for HIV/AIDS] and we are increasing the number of people who are eligible for treatment," she said. "So, we will see less and less of AIDS. But we will see higher levels of co-infection between TB and HIV."
Dr Simelela also argued that the country's TB control programme needs more resources. "It’s only right for us to resource [TB] in the same way that we are resourcing HIV," she said. "Because if you want to improve mortality for those who have got HIV you have to control the TB, you have to manage TB, you have to stop people from getting tuberculosis".
SANAC added TB to its mandate after the World Health Organisation (WHO) reviewed South Africa’s national TB control programme in 2009. The review found extremely high rates of TB and HIV co-infection in South Africa, with more than 70% of TB patients found to be HIV-positive in some parts of the country.
TB is now fully integrated into the way that SANAC works. "What we’ve got now is experts on TB represented on the SANAC structures, the Treatment Task Team of SANAC now includes the TB-HIV experts," Dr Simelela says.
One of SANAC’s priorities is to increase the number of people living with HIV who receive preventative treatment against TB. But Dr Simelela is concerned with the rate of progress.
Dr Simelela says that the service needs strengthening and that SANAC is working with a range of organizations to remedy the problem. "We’ve spoken to the Clinicians’ Society for HIV. We are speaking to the South African Medical Association to really promote this message and to really get all the doctors in South Africa and the nurses who are managing patients at the primary health care facility - even in the private sector - to provide Isoniazid treatment," she said.
Read the full story and interview transcript on the health-e website.