Tuberculosis TB

Eliminación de las muertes por tuberculosis: hora de intensificar la respuesta al VIH

20 de julio de 2014

En los últimos 10 años, se ha producido un progreso significativo en la respuesta a la tuberculosis relacionada con el VIH (TB) con una ampliación de las intervenciones integradas de TB y VIH, lo que ha permitido salvar aproximadamente 1,3 millones de vidas entre 2005 y 2011. Sin embargo, la tuberculosis representó unas 320 000 muertes relacionadas con el SIDA en 2012, y la gran mayoría de los países (más del 80%) todavía no está proporcionando terapia de medicamentos preventivos de la TB para aquellos que lo necesitan.

Una consulta de alto nivel, celebrada el 20 de julio durante la conferencia sobre el sida de 2014 de Melbourne, Australia, reunió a los líderes en la respuesta mundial al VIH para trabajar para la eliminación de las muertes por TB, la intensificación de la respuesta al VIH y el logro de un mayor compromiso político con este problema crítico, pero a menudo pasado por alto.

La reunión examinó el progreso en las respuestas regionales y globales, y analizó las brechas y barreras con el fin de lograr la eliminación de las muertes relacionadas con TB/SIDA, lo que incluye la necesidad crítica de herramientas de diagnóstico en el punto de atención para la tuberculosis y la simplificación de los tratamientos farmacológicos. Los participantes también identificaron los siguientes pasos cruciales, como las oportunidades para solucionar las lagunas de la investigación y el fomento de la innovación tan necesaria.

Organizado por la Organización Mundial de la Salud (OMS), la sesión fue presidida por Hiro Nakatani, subdirector general de la OMS para VIH/SIDA, tuberculosis, malaria y enfermedades tropicales desatendidas. Entre los participantes se encontraban Gottfried Hirnschall, director del Departamento de VIH/sida, OMS, Mark Dybul, director ejecutivo del Fondo Mundial de Lucha contra el Sida, la Tuberculosis y la Malaria, la embajadora Deborah Birx, coordinadora global de Sida de Estados Unidos, Anthony Fauci, director del Instituto Nacional de Alergias y Enfermedades Infecciosas de Estados Unidos, y Lucy Chesire, directora ejecutiva del Grupo de Acción de la Tuberculosis, así como representantes de los gobiernos de Camboya, India y Vietnam.

Citas

"Se ha avanzado y gran parte en los países más afectados del sur de África".

Gottfried Hirnschall, director del Departamento de VIH/Sida de la Organización Mundial de la Salud

"Si el 70% de los pacientes de tuberculosis con VIH conocen su estado, es inaceptable que sólo el 50% de ellos estén recibiendo tratamiento para ambas enfermedades en varios países del África subsahariana".

Deborah Birx, cordinadora global de Sida de Estados Unidos

"Todas las comunidades de salud pública deben unirse en el interés de las personas que padecen varias enfermedades o que están en riesgo de padecerlas".s."

Mark Dybul, director ejecutivo del Fondo Mundial de Lucha contra el Sida, la Tuberculosis y la Malaria

Unión Africana: traducir los compromisos políticos en acciones

30 de junio de 2014

Los jefes de estado africanos se comprometieron a apoyar los esfuerzos por acabar con el sida la tuberculosis y la malaria mediante la adopción de las recomendaciones recogidas en un informe de AIDS Watch Africa - que incluye dar prioridad al sida, la tuberculosis y la malaria en los nuevos objetivos de desarrollo con el fin de garantizar que la continuidad de la financiación internacional de la respuesta no se vea amenazada -, durante la 23ª Cumbre de la Unión Africana, celebrada del 20 al 27 de junio en Malabo (Guinea Ecuatorial).

El informe de AIDS Watch Africa, un instrumento africano para estimular a los líderes a actuar y para movilizar los recursos necesarios para combatir el sida, la tuberculosis y la malaria de una manera eficaz, sostenible y responsable, recalca la necesidad de una ayuda internacional continuada con el espíritu de la responsabilidad compartida y la solidaridad mundial. Sin embargo, también subraya la importancia de desarrollar soluciones para una financiación nacional innovador de la salud e insta a los países a seguir dando prioridad a las respuestas basadas en los derechos.

Durante su visita a Guinea Ecuatorial, Michel Sidibé se reunió con Teodoro Obiang Nguema Mbasogo, presidente de Guinea Ecuatorial, donde prometió prestar la asistencia técnica de ONUSIDA a fin de lograr una respuesta al VIH más eficaz y coordinada. El Sr. Sidibé también se reunió con el presidente de Uganda, Yoweri Museveni, quien anunció que volverá a enviar al Parlamento para su revisión la controvertida ley sobre prevención y control del VIH y sida de 2010 implantada el 19 de mayo.

Durante su estancia en Malabo, el Sr. Sidibé también participó en la Asamblea General extraordinaria de la Organización de Primeras Damas Africanas contra el VIH y el sida (OAFLA). En esta Asamblea General, las primeras damas presentaron su informe de actividad, que incluye planes para reducir al mínimo el número de mujeres infectadas y afectadas por el VIH en sus países, el papel de los curanderos tradicionales para lograr el acceso universal al tratamiento contra el VIH y la prestación de revisiones pre y postnatales gratuitos para las mujeres.

Citas

"África se compromete a lograr un continente sin sida".

Mohamed Ould Abdel Aziz, presidente de Mauritania y presidente de la Unión Africana

"ONUSIDA está dispuesta a asegurarse de que el trabajo acordado en el continente se traduzca en planes de actuación regionales y nacionales".

Michel Sidibé, director ejecutivo de ONUSIDA

Erradicación de las muertes por tuberculosis

New data shows progress in addressing TB/HIV

08 de diciembre de 2009

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Some 36 million people have been cured of tuberculosis (TB) over the past 15 years through a rigorous approach to treatment endorsed by the World Health Organization (WHO). New data, released by WHO, also indicate that up to 8 million TB deaths have been averted, confirming the Stop TB Strategy as the most cost-effective approach in the fight against TB.

The WHO update also shows continued progress on addressing the lethal combination of TB and HIV. Between 2007 and 2008, 1.4 million TB patients were tested for HIV, an increase of 200, 000. Of those who tested HIV positive, one-third benefited from life-saving HIV anti-retroviral therapy (ART) and two-thirds were enrolled on co-trimoxazole prophylaxis to prevent the risk of fatal bacterial infections. In addition, screening for tuberculosis and access to isoniazid preventive therapy for TB among people living with HIV more than doubled, although the total number is still far short of what it should be.

"Fifteen years of TB investments are bringing visible results in terms of human lives saved. Together, national programmes, WHO, UNAIDS, the Global Fund and other partners have helped save millions of lives from TB," said Dr Mario Raviglione, Director of WHO's Stop TB Department. "But the current pace of progress is far from sufficient to decisively target our goal of TB elimination."

The WHO Stop TB Strategy has five elements: political commitment with increased and sustained financing, case detection through quality-assured bacteriology, standardized treatment with supervision and patient support, an effective drug supply and management system, monitoring and evaluation system and impact measurement.

Data from the latest 12 month period now show that the highest ever number of infectious patients - 2.3 million people - were cured. With 87% of treated patients cured, the 85% global target was exceeded for the first time since it was established in 1991. Furthermore, a total of 53 countries surpassed this treatment milestone.

Fifteen years of TB investments are bringing visible results in terms of human lives saved. Together, national programmes, WHO, UNAIDS, the Global Fund and other partners have helped save millions of lives from TB.

Dr Mario Raviglione, Director of WHO's Stop TB Department

Although more and more patients are being cured, there are millions who are being let down because they are unable to access high-quality care. TB remains second only to AIDS in terms of the number of people it kills. In 2008, 1.8 million people died from TB including half a million deaths in HIV related illness–many of them because they were not enrolled on ART.

A persistent challenge that is largely left unchecked in many parts of the world is multidrug-resistant TB (MDR-TB) and its even more dangerous form, extensively drug-resistant TB (XDR-TB). Of the estimated half a million MDR-TB cases occurring per year, almost 30 000 were officially reported and 6 000 were known to be treated according to WHO international standards in 2008. A major expansion of services is currently in an early and difficult phase but almost 29 000 people are expected to be treated in 2010.

Of the estimated 9.4 million TB cases in 2008 (including 1.4 million TB/HIV cases), 3.6 million cases occurred among women.

"Half a million women died from TB last year. It is a disease that destroys lives, damages families and stifles development," said Dr Mario Raviglione. "Without help to fill the US$ 2 billion funding gap for TB care and control in 2010, the most vulnerable people will continue to miss the benefits so many others have seen."

The new report provides the most accurate information on the global burden of tuberculosis. It also features updates about the work of the Global Laboratory Initiative, the WHO Global Task Force on TB Impact Measurement, and describes the success of a new initiative in 2009 in which global TB data collection went online.

European meeting discusses migration, TB and HIV

15 de octubre de 2007

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UNAIDS Deputy Director Michel Sidibe with former
President of Portugal and United Nations Special
Envoy to the Stop TB Programme, Jorge Sampaio.

Migration, mobile populations and tuberculosis were priority focus areas at the meeting of EU national AIDS Coordinators, organized by the Portuguese Presidency of the European Union. UNAIDS Deputy Director Michel Sidibe stressed that increased action in these areas is vital in the goal of universal access to HIV prevention, treatment, care and support.

“European governments have a big part to play in making universal access a reality,” said UNAIDS Deputy Director, Michel Sidibe. Underlining commitments on AIDS made by the EU member states, he urged governments to “provide leadership and funding at home and abroad [with] a special duty to support neighbours in Eastern Europe and North Africa.”

Held as part of the events organized during the Portuguese Presidency of the EU, participants included representatives from EU Member States and neighbouring countries.

With increased labour migration, or the movement of people across borders in the region, the issue of AIDS specific issues and responses concerning migrants and mobile populations in Europe was high on the meeting agenda.

Numerous factors related to migration, including socio-economic and cultural factors as well as government processes and the conditions in destination countries, impact on HIV risk and the rights of migrants living with HIV.

“AIDS spreads as economies boom - as people move from rural to urban areas, from country to country, in search of a better life,” said UNAIDS Deputy Executive Director Michel Sidibe, underlining that movement across borders introduces HIV risk as people spending long periods of time away from home are more likely to engage in casual sex, may be placed in situations which make them vulnerable to HIV and often find themselves living on the margins of society, where they cannot access the HIV prevention and treatment services they need.

“This is made worse when there is no consistency between States regarding access to HIV services. In some countries undocumented migrants can access services – provided they know where to go. In others they can’t. In some, they have to pay at point of service delivery; at others they don’t. This is not universal access!” Sidibe said, noting that UNAIDS, the International Labour Organization and the International Organization of Migration are currently drafting a policy on HIV and migration which is expected for release shortly.

Focus on migrant workers within the AIDS response is key, he underlined, “for humanitarian and human rights reasons. For public health reasons and for socio-economic reasons: if migrants are healthy, they can make an active contribution to economic growth.”

Sidibe noted Portugal’s response to the issue of HIV and migration as an example of best practice that should be built on across the EU. “Portugal has blazed a brave trail in two key areas - introducing harm reduction programmes for injecting drug users and providing HIV services to migrants – documented and undocumented,” he said.

Tuberculosis and the interaction between TB and HIV epidemics in the region was also a key focus area for the EU meeting. The development and spread of multi-drug resistant and extensively drug resistant tuberculosis, especially among people living with HIV, was underlined as a serious concern for Europe and Africa, and one that threatens the achievement of universal access and the millennium development goals.

Underlining the need for a joint response to TB and HIV in the region and worldwide, the UNAIDS Deputy Executive Director met with former Portuguese President and UN Special Envoy to the Stop TB Partnership, Jorge Sampaio. At the meeting, Sidibe stressed UNAIDS commitment to advocating for a joint response on TB and HIV and encouraged Special Envoy Sampaio to continue his important work on these key health issues.

During his intervention in Lisbon, the UNAIDS Deputy Executive Director also met with the Portuguese Minister of Health, Mr Correia de Campos, Secretary of State for European Affairs, Mr Manuel Lobo Antunes and with the Executive Secretary of the Community of Portuguese-speaking Countries, Ambassador Luís de Matos Monteiro da Fonseca. In all meetings, Sidibe underlined the importance of the next European Union - Africa Summit and that it will be crucial to have AIDS on the agenda.

“We must lead by example and assure universal access to HIV prevention, treatment, care and support within this region by 2010,” said Sidibe.


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