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.
- 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
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).
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.