AIDS must not be allowed to mask another vital battle – that against TB

[9 December 2008 - 08h37]
[mis à jour le 9 December 2008 à 17h37]

Medication alone cannot conquer the AIDS pandemic, but it can achieve a great deal. Providing it’s used properly!

This obvious fact was at the centre of the debates at the 8th International Conference on AIDS and Sexually Transmissible Infections (STIs) held in Dakar (Senegal). Because although observance of treatment is fundamental to success, the fact that HIV is being treated must not overshadow the need for treatment of opportunistic diseases. And at the forefront of these is tuberculosis.

As Alastair Reid of UNAIDS reminds us, tuberculosis “is the principal cause of illness and mortality among people living with HIV in Africa. And yet it can be treated and avoided…”. In Dakar, in association with the Stop TB Partnership and the World Food Programme, the Agency ran sessions on the implementation of what it calls “the three ‘I’s rule: Intensification of TB screening; preventive use of Isoniazide (anti-TB reference drug, ed.); and Infection control to reduce the burden of TB”. An invaluable and timely reminder is that “in 2006, for example, only 22% of people affected by TB in sub-Saharan Africa were tested for infection with HIV. And less than 1% of HIV-positive patients received screening for TB…”

Once the illness has been unmasked, therapeutic observance is an absolute imperative. In this respect, the role of those in charge of town pharmacies – known in international jargon as community pharmacies– is absolutely essential. The Sidaction association in fact ran a “reinforcement session” aimed specifically at them. This reiterated the importance of the “Good Pharmaceutical Practice Guide drawn up by the International Pharmaceutical Federation (IPF) following lengthy consultation with pharmacists’ professional associations across the world. Simple and locally adapted “it helps to improve all practices, from stock management, via nutritional recommendations, to advice when dispensing.”

France’s commitment will not be challenged by the crisis Because everything matters. “How can we identify and support patients who fail to observe treatment; how can we adapt the taking of antiretrovirals during Ramadan?” These are the questions facing pharmacists on a daily basis and their “role and importance (…) must be better recognised. They must be better integrated into proposed in-service training”, Sidaction representatives point out.

Screening, promoting information, patient education, in-service training for professionals in the field … there is no shortage of imperatives. The fight against HIV in Africa has perhaps made more headway in the last 6 years than during the previous 20 but while progress has been immense, the challenge remains considerable. And Africa will not face it alone. International support is more necessary than ever because HIV knows no boundaries. Any more than any other disease.

“Be assured that France will not abandon its substantial contribution to the World Fund – the leading contribution in terms of size in the European Union and the second largest in the world – nor its very considerable participation in UNITAID”. Roselyne Bachelot-Narquin, French minister responsible for health, is leading the way in this respect. And she reminds us that in 2007 “France committed more than 364 million euros to this fight (and that there) can never be a question of abandoning these diplomatic priorities as a result of the global economic and financial crisis.”

Source : from our special correspondent at the 8th International Conference on AIDS and Sexually Transmissible Infections (STIs), Dakar, 3-7 December 2008.

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