Tuberculosis (TB) remains one of the world’s deadliest infectious diseases. The risk of developing TB among the millions of people living with HIV (PLHIV) is 18 times higher than in the rest of the global population. An estimated eight percent of the reported TB cases in 2020 were among PLHIV, and 214,000 TB deaths were among HIV-positive people. TB remains not only the world’s leading infectious-disease killer in low- and middle-income countries, but also the overall leading cause of death among PLHIV, accounting for around 30 percent of AIDS-related deaths. HIV and multidrug-resistant TB (MDR-TB) are a particularly deadly combination. Even with early diagnosis and treatment initiation, PLHIV with MDR-TB are more likely to die.
Because of the significant risk presented to both individuals and programs, addressing the dual TB and HIV epidemics is a top priority for the United States Agency for International Development (USAID), the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), and for national TB and HIV programs globally. Ensuring that HIV-positive patients are screened, tested, and, as necessary, referred for and started on treatment or preventative therapy for TB is key to simultaneously combating these epidemics.
USAID’S RESPONSE
Since 2000, USAID and partners have saved more than 66 million lives globally, including 12 million lives of people living with TB and HIV.
USAID leads the U.S. Government’s global TB efforts, working with agencies and partners around the world to reach every person with TB, cure those in need of treatment, prevent the spread of new infections, and stop the progression to active TB disease. USAID is a key implementer of PEPFAR programs to address the specific challenges presented by TB/HIV by implementing collaborative TB/HIV activities to make progress on:
- Assisting with establishing and strengthening the mechanisms for coordination of TB and HIV activities and services;
- Decreasing the burden of TB in PLHIV;
- Decreasing the burden of HIV in individuals with active TB; and
- Initiating early antiretroviral treatment for PLHIV with active TB disease to increase survival and improve quality of life;
USAID also works closely with the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and National TB and HIV Programs to further maximize the impact of the Global Fund’s TB and TB/HIV grant portfolio.
USAID works with partners and local governments in all PEPFAR-funded countries to implement interventions that scale-up effective TB/HIV interventions aimed at reducing the burden of TB for PLHIV.
USAID’s TB program focuses on reducing the HIV burden among TB patients. Our efforts ensure that individuals with TB know their HIV status via testing during TB clinic visits and that HIV-positive TB patients are linked to care and to receive antiretroviral therapy (ART) as appropriate.
2021 Achievements
In FY 2021, PEPFAR-funded TB/HIV activities through USAID programs contributed to reducing the burden of TB among PLHIV via:
- TB screening of 5,835, 086 PLHIV on ART;
- Detection of 28,673 new clinically diagnosed TB cases among PLHIV:
- TB treatment initiation for 46,598 TB/HIV patients;
- TB Preventive Treatment initiation among 1,383,851 PLHIV; and
- TB Preventive Treatment completion among 1,114,249 PLHIV.
USAID PEPFAR TPT and TB Screening for PLHIV trends, FY 2021 successes
In FY 2021, USAID Programs contributed to reducing the burden of HIV among TB patients by:
- Ensuring that 97% of the individuals with TB were tested for HIV;
- Linking 91% of individuals with TB and HIV to ART regimens.
ADDITIONAL RESOURCES
To learn more about how USAID works closely with host countries, other U.S. Government agencies, and international partners to reduce the morbidity and mortality associated with TB and TB/HIV, please visit:
- USAID TB Division Webpage
- USAID Office of HIV and AIDS Webpage
- Success Story: Improving Diagnostics and Labs in Zambia
- PEPFAR Official Website
- PEPFAR MERS indicator reference guide