1. PEPFAR support for the scaling up of collaborative TB/HIV activities.
- Author
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Howard AA, Gasana M, Getahun H, Harries A, Lawn SD, Miller B, Nelson L, Sitienei J, and Coggin WL
- Subjects
- AIDS-Related Opportunistic Infections diagnosis, Acquired Immunodeficiency Syndrome diagnosis, Africa South of the Sahara epidemiology, Communicable Disease Control methods, Communicable Disease Control trends, Developing Countries, Humans, International Cooperation, National Health Programs organization & administration, National Health Programs trends, Public-Private Sector Partnerships organization & administration, Public-Private Sector Partnerships trends, Tuberculosis diagnosis, United States, AIDS-Related Opportunistic Infections drug therapy, Acquired Immunodeficiency Syndrome complications, Acquired Immunodeficiency Syndrome drug therapy, Communicable Disease Control organization & administration, Global Health, Tuberculosis complications, Tuberculosis drug therapy
- Abstract
The US President's Emergency Plan for AIDS Relief (PEPFAR) has supported a comprehensive package of care in which interventions to address HIV-related tuberculosis (TB) have received increased funding and support in recent years. PEPFAR's TB/HIV programming is based on the World Health Organization's 12-point policy for collaborative TB/HIV activities, which are integrated into PEPFAR annual guidance. PEPFAR implementing partners have provided crucial support to TB/HIV collaboration, and as a result, PEPFAR-supported countries in sub-Saharan Africa have made significant gains in HIV testing and counseling of TB patients and linkages to HIV care and treatment, intensified TB case finding, and TB infection control. PEPFAR's support of TB/HIV integration has also included significant investment in health systems, including improved laboratory services and educating and enlarging the workforce. The scale-up of antiretroviral therapy along with support of programs to increase HIV counseling and testing and improve linkage and retention in HIV care may have considerable impact on TB morbidity and mortality, if used synergistically with isoniazid preventive therapy, intensified case finding, and infection control. Issues to be addressed by future programming include accelerating implementation of isoniazid preventive therapy, increasing access and ensuring appropriate use of new TB diagnostics, supporting early initiation of antiretroviral therapy for HIV-infected TB patients, and strengthening systems to monitor and evaluate program implementation.
- Published
- 2012
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