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Why Aren't More HIV-Positive People Being Screened For TB?

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By Meaghan Derynck, TB Project Officer, RESULTS Canada

With the end of the Millennium Development Goals (MDGs) and the kick-off of the Sustainable Development Goals (SDGs), 2015 has been an outstanding year for advancements in global health: we now have potentially viable vaccines for both Ebola and malaria, child survival rates are the highest they've ever been, and the world is on track to exceed the target of placing 15 million people in low and middle-income countries on antiretroviral therapy (ARTs).

But 2015 hasn't been all good news. In October the WHO released their annual Global TB Report, and the picture it paints is much less rosy. As the report outlines, TB is now responsible for the deaths of 1 in 3 people with HIV, up from 1 in 4 just last year, and has been officially named the world's No. 1 infectious disease killer.

TB kills approximately 1.5 million people each year -- that means that you are more likely to die of TB than you are in a car crash. Though often labelled as a disease of poverty because many of its major contributing factors are conditions typically associated with poverty (such as living in cramped, poorly ventilated housing, and a lack of access to quality healthcare services), the reality is that 72% of the overall disease burden is found in lower and upper middle-income countries. The exact same is also true of HIV.

At home in Canada we don't even need to look beyond our own borders to see the devastating effects of TB and HIV. Canada's indigenous people make up approximately 3% of the total population of the country, and yet account for an estimated 6-12% of new HIV infections annually. In Nunavut alone, the rates of TB are comparable to any sub-Saharan African country; the incidence rates among Nunavummiut are almost 400 times higher than amongst non-aboriginal people.

The SDGs are a set of 17 goals that aim to address some of the world's most pressing issues including ending poverty, hunger, and ensuring access to education, water and sanitation, and good health and well-being. This is an increase from the 8 MDGs that expired this year, and yet, it has been said that the new goals are meant to encourage more partnership and fewer silos -- but with more goals, and a growing number of social media campaigns asking people which goal they are most interested in, it certainly seems the opposite is happening. If we cannot achieve 8 broader-based goals in 15 years as a global community, how do we expect the world to rally around and achieve 17 goals in as many years?

There has long been a strong push for better cohesion and collaboration between TB and HIV service delivery to help address the exceedingly high co-infection rates, but the mechanisms and groups leading this charge, such as The Global Fund to Fight AIDS, TB and Malaria, focus the bulk of their efforts on low-income countries, while enormous disconnects still exist in middle-income countries. Even in Canada, it is recommended that all HIV-positive people are tested for TB, and vice versa, and yet it's estimated that only 21% of HIV-positive people have been screened for TB.

There is no doubt that the SDGs have presented the world with a daunting task. That's not to say that we cannot achieve the goals, but in order to be truly successful and be able to claim a job well done in 2030, countries like Canada need to be introspective and ensure that we are imposing the same expectations on ourselves as we are the rest of the world.

Meaghan Derynck is TB Project Officer at RESULTS Canada, national advocacy organization with a network of volunteers committed to creating the political will to end global poverty. RESULTS Canada is a member of the ACTION global health advocacy partnership.


This blog is part of a World AIDS Day series produced by the Interagency Coalition on AIDS and Development (ICAD) in recognition of World AIDS Day (Dec 1). The series runs from Dec. 1-7, 2015 and will feature a selection of blogs written by our member and partner organizations. Each day we will hear from a broad range of experiences in blogs written by ICAD members. Each provides their perspective and their insight on what must be done to achieve the UNAIDS campaign of "Getting to Zero" as we embark on the race to meet our 2030 Goals for Sustainable Development.

Disclaimer: The views and opinions expressed in this blog series are those of the authors and do not necessarily reflect those of ICAD.