World TB Day and The U.S. President’s Emergency Plan For AIDS Relief (PEPFAR)

March 23, 2007

March 24 marks World TB Day – a day that highlights the global threat of tuberculosis.  The theme of the 2007 World TB Day is: “TB Anywhere is TB Everywhere,” underscoring the fact that TB affects all corners of the globe.

Nigeria has highest TB burden in Africa and ranks fourth among the 22 high burden countries for TB globally.

HIV positive persons are especially susceptible to developing TB, which is the leading cause of death among people living with HIV/AIDS.  Health facility based estimates in Nigeria show that up to 20% to 40% of HIV positive patients have active TB.  The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is responding with urgency appropriate to this challenge.

Currently the U.S.Government is the major donor supporting and providing technical assistance to TBHIV activities in Nigeria. PEPFAR provides technical support and funding to the Federal Ministry of Health, international and local organizations, community and faith based groups to implement TBHIV activities in Nigeria.

The U.S. Government has adopted, as part of its 5-year PEPFAR strategy, a plan to provide HIV counseling and testing to all TB patients; to ensure adequate screening, diagnosis, and treatment of TB for all HIV infected individuals; to support linkage between the TB and HIV care program to increase access to care for TB/HIV

Nigeria currently has over 2,000 TB diagnostic and treatment facilities offering Directly Observed Treatment Services (DOTS) in 65% of Local Government Areas.  More than 40% of notified TB cases in 2005 were diagnosed and treated in states where the U.S. Government provides support for TB control activities. The reported TB treatment success rate is 79%.  In these states approximately 7,000 HIV patients with dual infection were treated for TB.

PEPFAR support for TB/HIV programs has increased more than eight-fold in just three years – from just fewer than one million dollars ($887,000) in fiscal year 2004 to $7.8 million in fiscal year 2007. Through PEPFAR, the U.S. Government is the largest contributor to the Global Fund, providing approximately one-third of the Fund’s resources.  Through 2007, the Global Fund will have committed $1.4 billion to TB grants.

The emergence of drug-resistant strains of TB are of special concern – especially what is known as extensively drug-resistant TB.  To date, extensively drug-resistant TB is virtually untreatable, and almost universally fatal to people who are HIV-positive. PEPFAR is supporting the efforts of the Federal Ministry of Health to establish Tuberculosis Multi-Drug Resistance control program in Nigeria.

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