The ManicaPost
Catherine Murombedzi HIV Walk
IT is high time there is a collaborative TB-HIV treatment if we are to have quality life for people living with HIV.
Taking medication for HIV daily is already a burden and for TB co-infection, the tablets to be swallowed by a patient daily become a mouthful.
To understand the pill burden, remember one day you went down with a common cold and had to take two or three tablets for a prescribed treatment time. The moment you got better you stopped the treatment without finishing the course. For people living with HIV and on life treatment, stopping medication is not an option. Anti- retroviral tablets are taken for life.
With a weakened immune system, a person living with HIV is prone to get opportunistic infections and TB topping the list of infections. TB is caused by TB bacillus. TB is a major killer surpassing HIV and Aids.
Recently when attending a workshop for meaningful involvement of people living with HIV (MIPA) organised by the National AIDS Council in Gweru, the Provincial Medical Director for Midlands Province, Dr Charles Moyo, said it was imperative that people living with HIV take precautionary TB medication.
“For people living with HIV, it is important that they take Isoniazid tablets as a measure to prevent tuberculosis infection. The tablets are taken for six months and this helps in TB prevention,” said Dr Moyo.
Being a journalist and a person living with HIV, I asked why this is not offered when one collects their ARVs. Most people in the meeting professed ignorance of the prevention treatment. They, however, lamented the pill burden with the addition of the TB prevention medication.
“This is the first time I am hearing that there is TB prevention. I have been living with HIV for the past 10 years and five years ago I got tuberculosis. So I am surprised, why the prevention is not offered to one when starting ART because getting TB-HIV co infection and the amount of tablets to be taken is too much,” said Emmanuel Gasa, an activist and founder for internally displaced people in Zimbabwe.
Gasa went on to say that knowledge is power and would enquire at his local clinic about the service.
At a Press briefing at the recent ended 21st AIDS conference in Durban, South Africa civil society demanded collaborative TB-HIV treatment as a matter of urgency. Civil society liaison officer consultant, Nomampondo Barnabas, said integration should not just be about one-stop services, it should encompass a fixed dose combination for co-infection.
“Currently there are just too many tablets that one has to take when co-infected with TB-HIV. The pill burden is high and this adds to lack of adherence. I am not a medical person, but I feel there is need to come up with one pill, combining TB and HIV treatment,” said Barnabas.
Barnabas has lived with HIV for nearly two decades and called on policy makers to listen to affected voices.
“Before any programming is done, there is need to listen so that we don’t lose gains made in the fight against HIV and TB,” said Barnabas.
Barnabas is also an officer for The Union in South Africa. The TB-HIV burden is also high in Zimbabwe with 70 percent of TB patients testing HIV positive too.
Dr Zishiri, country director, The Union (Zim), said gains made in the fight against HIV and TB must not be lost. Through Challenge TB in Zimbabwe, the country has managed to make TB-HIV services integrated.
“Through our Challenge TB, we have through the Ministry of Health and Child Care integrated services around the country, but I believe more can still be done to encourage adherence and lessen the pill burden,” Dr Zishiri said.
He called on pharmaceutical companies to heed the call.
“It is something important that pharmaceutical companies can think of to combine TB-HIV treatment,” added Dr Zishiri.
According to the Global Report on TB, the world’s deadliest communicable disease remains tuberculosis.
“Of the nine million people estimated to have developed TB 1,5 million died from the disease. Of these 360 000 were HIV positive,” the report noted.
With governments of all UN-member nations in 2015 at the UN General Assembly gave commitment to achieve Sustainable Development Goals (SDGs) one of which is to end AIDS by 2030. If people living with HIV continue to die of TB, the gains made in the fight against AIDS and TB will be eroded. TB screening for all people living with HIV should be an on-going measure.
Shingirayi Matogo, an activist and founder member of Clear Vision, an organisation working in Glen View, south west of Harare, said it was sad to see people dying of TB today, something that is preventable and curable.
“It is sad to have people dying of TB in this age. It is not always that a person infected with TB coughs. Recently I was bereaved in the extended family and it pains me. Losing a young life to tuberculosis is something that can be prevented. That was a premature death. The young man never coughed, but I feel that the moment he tested HIV positive, they should have screened him for TB. By the time he was admitted it was too late and we lost him,” said Matogo.
A participant at the MIPA workshop said he had on two occasions suffered from TB.
“I have been on ART since 2004 and I am happy to say I am still on first line treatment.
“My concern is that I fail to understand why I keep being infected with TB. The first time was before I knew that I was HIV positive. So as I was receiving tuberculosis treatment I was screened for HIV and found to be positive,” he said.
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