Implementing collaborative TB-HIV activities: a programmatic guide

A new practical guide for healthcare workers and HIV and tuberculosis (TB) programmes on how to implement TB-HIV collaborative activities (health services that reduce the burden of either TB or HIV, and sometimes both diseases, as well as the activities required to support those services) has just been released by the the Union (the International Union Against Tuberculosis and Lung Disease).

Since WHO’s Policy on Collaborative TB-HIV Activities was released in 2004, it is estimated that the implementation of collaborative TB and HIV services have saved more than 910 000 lives.

The WHO policy, updated earlier this year, describes actions that should be taken by national programmes to improve collaboration at the programmatic levels, and services that should be provided at the point of care by each programme to reduce the burden of the other disease in the patients in their services.

For instance:

• Any person diagnosed with TB should receive HIV counselling and testing services, given the high rate and health risks associated with coinfection.

•  Anyone taking TB treatment who tests HIV-positive should be placed on co-trimoxazole preventive therapy, and antiretroviral therapy as soon as possible — and those who test HIV-negative should be provided with HIV prevention services.

• HIV programmes should offer TB patients the ‘Three I’s for HIV/TB’: good TB infection control, and intensified TB case finding (ICF) to find and treat TB cases among people living with HIV and to identify people who qualify for isoniazid preventive therapy (IPT).

 Recognising a need to show healthcare professionals workers and programmes just how to organise and make these policies work on the ground, the Union — an organisation consisting of over 3000 of the leading organisations and experts working in the field of tuberculosis and other health challenges in low- and middle-income populations — have pooled together in this guide its considerable experience in developing approaches to integrated TB-HIV care for adults in resource-limited settings

The guide offers the Union’s expertise “from the point where health services are delivered to the level of the policy-making institutions within a country.” This includes practical tips for primary healthcare workers “for their daily work, while managers and policy-makers may find solutions to the constraints they face. Practical suggestions are provided to programme managers and health workers on how to plan, organise and mainstream collaborative TB-HIV activities into their TB and HIV services within the public health system.”

In one chapter the guide focuses on how to finance and obtain technical support and other resources needed to provide TB-HIV services. Another addresses the mechanics of setting up a TB-HIV coordinating body, and who should be its membership (hint, include representatives from civil society, and the community living with HIV and affected by TB).

The guide provides practical recommendations in a question-and-answer format for the target audience of health planners, managers, and health workers in resource-constrained settings. It is recommended for healthcare professionals at both the implementation level and national programme staff in charge of policy and practices for collaborative TB-HIV activities. At present, it can be downloaded in English (PDF 483.9 KB) or one can order the print version.

Watch this space for links for translations in other language as they are released, and for links to the Union’s many other useful publications.

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