A new research report from ACTION global health shows that joint TB-HIV activities are neglected by HIV programs and overwhelmingly carried out by TB programs, and that global guidelines to address TB-HIV have not been prioritized by leading donors and affected countries.
The report was released at the 2014 International AIDS Conference in Melbourne, Australia.
Originally developed in 2004, World Health Organization’s (WHO) 12 guidelines on collaborative TB-HIV activities act as global direction on TB-HIV integration efforts. This is the first time a comprehensive study across multiple countries and donors has examined the extent to which these guidelines have translated into policy and programing realities.
Major findings include:
- Underfunded TB programs carry out the majority of joint TB-HIV efforts, while TB-HIV interventions are often neglected by HIV programs. For example, Global Fund TB grants had a budget one-eighth the size of HIV grants, yet allocated nearly three times the total amount of TB-HIV funding.
- The US President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria have been quick to update their policies to reflect WHO guidelines, while the UK Department for International Development (DFID) and the World Bank have been slow to implement WHO recommendations in their health programs.
- Failure to integrate TB and HIV programs creates barriers to TB diagnosis and treatment for people living with HIV/AIDS.
The report includes specific recommendations for the Global Fund, PEPFAR, DFID, the World Bank, national HIV Programs, and national TB Programs to scale up their efforts to fight the dual epidemics of TB and HIV.