30/06/2011
By VIOLET MENGO
AS TUBERCULOUS (TB) and HIV continue to ravage Zambia and many other sub-Saharan countries, researchers at the Zambia AIDS Related TB Project (ZAMBART) are leading a study whose results will help establish whether a mix of community-level interventions can halt the spread of TB and HIV in Zambia.
TB is the biggest killer of people with HIV, particularly in sub-Saharan Africa. The scientific community is aware of the link between the two diseases but communities where many people are hardest hit by the HIV plus TB may be unaware of the link between the two.
Formed in 1989 following a collaboration between the University of Zambia's School of Medicine and the London School of Hygiene and Tropical Medicine in the United Kingdom, ZAMBART is working with learning institutions in Zambia and around the world with the aim of coming up with a new method of tackling the co-epidemics.
For example, ZAMBART is currently finalising its Zambia-South Africa TB and AIDS Reduction (ZAMSTAR) study.
The ZAMSTAR study is a seven-year (2004 - 2011) US$15 million study, seeking to test interventions that can limit the spread of TB at the community-level. The study is a randomised trial that took place in 24 communities - 16 in Zambia and eight in Western Cape of South Africa. This study, the largest ever of its kind, touched over 1.2 million people.
The ZAMSTAR study is funded by the Bill & Melinda Gates Foundation through the Consortium to Respond Effectively to the AIDS and TB Epidemics. TB is a bacterium that infects the lungs, and spreads between people living in over-crowed conditions. It is particularly a problem for people living in poverty, and for people infected with HIV.
In fact, TB is the leading cause of illness and death among people living with HIV and AIDS (PLWHA) in Zambia. About 70 percent of PLWHA are co-infected with TB and HIV, according to the World Health Organisation (WHO). Diagnosis depends mostly on a century-old approach of microscopy to look at smears of patients' sputum to identify the TB organisms visually, or through laboratory culture, which can take six to eight weeks.
For a period of three years (2006 - 2009), the ZAMSTAR study implemented a number of interventions at community level with the support of the District Health services.
The interventions included helping TB and HIV services work together (integration of TB and HIV service and care), finding more TB cases (enhanced TB case finding) and delivering TB and HIV care directly to households through a TB patient (household counselling).
In order to reach communities with messages on TB and HIV, the ZAMSTAR study utilised an array of different social mobilisation techniques. These included: drama performance, distribution of information, education and communication (IEC) materials, providing health talks within the community and at the clinic, going to schools and educating school children on TB and HIV with school quizzes, sport and health debate.
In each community team, ZAMSTAR members were embedded in the District Health Management Team and in the Ministry of Health facilities. Through the ZAMSTAR interventions, researchers are trying to measure how effective the interventions are at reducing the spread of TB and HIV at the community level.
"The ZAMSTAR has had a number of successes, it has been most rewarding to see, my greatest pleasure is to see that communities are much more aware about the link between HIV and TB and how it is important for them to seek prompt treatment from health centres," says Justin O'Brien.
ZAMBART Project Policy Advocacy and communication manager. The Zambian government through the Ministry of Health (MoH) also authorised ZAMBART to pilot Ionized Preventive Therapy (IPT) in all the communities where the ZAMSTAR study is being conducted.
IPT is given to individuals living with HIV but without TB to reduce their risk of developing TB. Past research has shown that IPT reduces incidence of TB by as much as 33 percent in those who take it.
In addition, IPT offers several key benefits which include: well tolerated with few side-effects, improves the quality of life of beneficiaries, leads to overall reduction of TB cases, reduces TB transmission within the family and the community and reduces the burden on the health care system.
ZAMBART installed four containerised laboratories within Zambia to process sputum samples and conducts extensive data collection training for its field teams.
These containerised TB laboratories, called ZamLab CTLs, were introduced in the country in an effort to conduct a large-scale TB prevalence survey in a less-developed country with a poor transportation network.
The use of these ZamLab CTLs in Zambia has proven so successful that labs are being ordered and constructed all over the world in countries such as Haiti, Kenya and Botswana. Treatment for TB involves drugs such as Rifampicin and Isoniazid, which takes six months to complete the treatment, and then six months of hospital visits to make sure the infection has been cleared. TB is curable when one finishes their treatment.
The Centre for Infectious Disease Research in Zambia (CIDRZ) is another non-governmental organisation which has been working with TB- related research in Zambia since 2008. One area of research focus is defining the best strategies for screening and treating patients infected with both HIV and TB. For example, CIDRZ recently completed an international study with AIDS Clinical Trials Groups (ACTG) on the best time to start antiretroviral drugs (ART) in patients with both TB and HIV.
All the TB studies we do at CIDRZ are relevant to Zambia and other resource- limited settings," CIDRZ Medical Director Dr Stewart Reid says. He says CIDRZ works closely with the Ministry of Health and the UNZA Biomedical Research Ethics Committee and external independent monitors to ensure that all ethical issues in research are adhered to.
The ACTG treatment study found that for patients with both TB and HIV, it is important to start ART early, especially in patients with advanced HIV disease. These results were shared with Dr Nathan Kapata, manager of the National Tuberculosis and Leprosy Programme at the Ministry of Health.
Sharing of information about research results between Zambia-based researchers and the MoH ensures that proven evidence identified through ethical research may be incorporated into policy so that Zambians benefit from the research done in the country. CIDRZ also works closely with the MoH in improving TB diagnosis in district clinics.
Dr Nzali Kancheya, head of CIDRZ TB Department, says there are many challenges in TB screening in HIV-positive patients. She explains that it is difficult to find the TB germ when the standard sputum smear microscopy is done. Up to 50 percent positive patients may be missed if smear alone is used.
As a result, CIDRZ is trying to investigate better ways of diagnosing TB in HIV-positive patients. "We are looking for more accurate, shorter and easier ways of diagnosing TB, Dr Kancheya says. One way of doing this is with a new instrument called Xpert MTB/RIP which has recently been approved by World Health Organisation (WHO).
It provides accurate results in less than 90 minutes and is more sensitive than older methods for diagnosing TB especially in HIV- infected individuals.
In addition to diagnosing TB, it can be used for rapid detection for multi-drug resistant TB (MDR-TB) and is recommended for use worldwide at district and sub-district level as a "point of care" diagnostic tool. CIDRZ along with the MoH is planning clinical trials of this promising tool in Zambia this year. With renewed interest in more research and funding, the fight against TB has moved a notch higher and may soon be won.
ENDS
Wednesday, September 28, 2011
Safe water access foundation to good health - Luangwa DC
By VIOLET MENGO
LUANGWA District Commissioner (DC) Musole Siachisa says over 80 boreholes have been sunk in the district to provide clean and safe drinking water for the people.
In an interview in Luangwa, Mr Musole said the district is characterised by poor water and sanitation facilities, but the provision of the boreholes has helped improve the livelihood of the people through reduction of diseases.
He said government is committed to providing the residents of Luangwa with clean and safe drinking water.
"Government recognises that access to safe drinking water is the foundation of good health especially among children," he said.
Mr Musole said although the demand for clean and safe water is still huge, efforts to address the challenge are being made by government and non governmental organisations.
The DC said government seeks to create, promote and support conditions within which access to improved water and sanitation can be based.
He said the boreholes have also helped to reduce the cases of water-borne diseases that are common in the district. And Childfund Zambia launched an improved water project in the district aimed at enhancing access to clean and safe water.
Twelve boreholes will be sunk in three communities at a cost of K1.2 billion. The villages are Chikonwelelo, Tigwilizane and Mandombe. National director Ely Keita said ChildFund believes that improved access to clean and safe water greatly reduces the number of children who die from water-borne diseases.
He said 12 boreholes willbe sunk and solar powered pumps to supply water to 10 000 litre pumps. "We have trained selected members of the communities who will help in maintaining the facilities that we are going to put in place," Mr Keita said. The improved water project will be extended to other parts of the district once the drilling in the three communities is completed.
ENDS
LUANGWA District Commissioner (DC) Musole Siachisa says over 80 boreholes have been sunk in the district to provide clean and safe drinking water for the people.
In an interview in Luangwa, Mr Musole said the district is characterised by poor water and sanitation facilities, but the provision of the boreholes has helped improve the livelihood of the people through reduction of diseases.
He said government is committed to providing the residents of Luangwa with clean and safe drinking water.
"Government recognises that access to safe drinking water is the foundation of good health especially among children," he said.
Mr Musole said although the demand for clean and safe water is still huge, efforts to address the challenge are being made by government and non governmental organisations.
The DC said government seeks to create, promote and support conditions within which access to improved water and sanitation can be based.
He said the boreholes have also helped to reduce the cases of water-borne diseases that are common in the district. And Childfund Zambia launched an improved water project in the district aimed at enhancing access to clean and safe water.
Twelve boreholes will be sunk in three communities at a cost of K1.2 billion. The villages are Chikonwelelo, Tigwilizane and Mandombe. National director Ely Keita said ChildFund believes that improved access to clean and safe water greatly reduces the number of children who die from water-borne diseases.
He said 12 boreholes willbe sunk and solar powered pumps to supply water to 10 000 litre pumps. "We have trained selected members of the communities who will help in maintaining the facilities that we are going to put in place," Mr Keita said. The improved water project will be extended to other parts of the district once the drilling in the three communities is completed.
ENDS
Lusaka General Hospital adds value to health sector
By VIOLET MENGO,
SINCE President Rupiah Banda assumed power in 2008, Government has been working round the clock to deliver on the promise and three years down the line many infrastructural developments have seen the light of day.
One of the major infrastructure developments the government of President Banda initiated is the Lusaka General Hospital (LGH). The multi-billion kwacha hospital built with the help from the Chinese government was on Monday commissioned by President Banda.
Mr Banda has put the improvement of the health sector top on the agenda and the opening of the Lusaka General Hospital is proof that the health delivery system is getting closer to the people.
Mr Banda commissioned the K48 billion new Lusaka General Hospital with a call on the district health management team to devise new and more effective ways of looking after public infrastructure and appealed to the public to desist from vandalism.
"My only plea to all of you is that you play a serious part in looking after these facilities and guard them jealously. Please play a role in discouraging vandalism, the hospital has been built for you at great cost and you must benefit from its services for a long time to come," said Mr Banda.
The opening of the 150-bed second level hospital is yet another indication of President Banda's desire to preside over an administration that is committed to taking quality and affordable health care as close to the people as possible.
The construction of the hospital is aimed at decongesting the University Teaching Hospital (UTH). Other clinics in Lusaka, such as Matero, Kanyama, Chawama and Chipata, have already been upgraded to mini-hospitals. The Lusaka General Hospital was constructed by China Jiangsu International Economic Cooperation under a grant by the People's Republic of China.
The newly-constructed hospital covers a floor space of 7,500 square metres with 150 sickbeds. Chinese Ambassador to Zambia Zhou Xiao said departments such as internal machine, surgery, gynaecology and Obstetrics, paediatrics, emergency, imaging and radiology will be set up to facilitate comprehensive medical services. Mr Zhou said China has equipped the hospital with 128 categories of modern medical equipment, laboratory facilities and auxiliary installations.
Other equipment include CT scanner, a digital X-ray machine, a coloured ultrasound system and fibre gastro scope.
Mr Zhou said more equipment would be made available to the hospital by China to meet the increasing needs. President Banda's Government has in the last two years built hospitals, health centres, health posts, training schools and houses for medical staff to enhance access to quality health care countrywide.
"My Government is determined to improve the health delivery system in the country so that our vision to provide Zambians with equity of access to cost- effective health care as close to the family as possible is realised. We are doing this by building modern district hospitals throughout the country," Mr Banda said.
The President said the Lusaka General Hospital is a high- tech shining example of the reliable and mutually beneficial relationship Zambia enjoys with the People's Republic of China.
Government is not only building hospitals, but also ensures that the facilities have sufficient drugs and are manned by a professional and motivated workforce in order to ensure that the hospitals have adequate manpower.
Mr Banda said a recruitment drive for manpower has been embarked upon both locally and abroad. For this year alone, Government allocated K52 billion to the Ministry of Health for the recruitment of different categories of health workers, and the process is ongoing.
"We have opened a new medical school at the Copperbelt University to train more medical and dental surgeons. We also hope to increase the intake of students in our institutions by expanding learning facilities and opening new ones," he said.
The introduction of new training programmes such as the direct entry training for midwives and parallel enrolment schemes for clinical officers have led to a significant improvement in the number of personnel in the country.
China has also decided to attach 11 Chinese volunteer doctors to the hospital while the 16th team with another 28 doctors is ready to leave China for Zambia anytime soon.
From 1978 to date, China has made 500 scholarships available to Zambia. 150 have completed their studies while others are still studying medical science in China. Among the 44 students who are going to study on Chinese scholarships this year, 13 of them will major in medicine.
The medical scholarships are aimed at helping Zambia's capacity building in the health sector, which is equally as essential as hospital building.
Mr Banda said the commissioning of the new district hospital in Lusaka is an affirmation of another great achievement Government has recorded for the people of Zambia. He said the new hospital is another demonstration of what Government is accomplishing to improve health service delivery to the people.
In the last two years Government has built hospitals, health centres, health posts, training schools and houses for medical staff to enhance access to quality health care.
All Zambians who appreciate the services being offered at various medical facilities in the country will admire and support the work Government is doing.
"We have been able to plan for the increasing demands by constructing the modern hospital. My Government is also aware that Lusaka faces many other health concerns such as HIV and AIDS, maternal health demands and critical injuries arising from road traffic accidents which will now be ably handled at the new hospital," Mr Banda said.
A Lusaka resident Margarate Chibwe, who witnessed the official opening of the hospital, commended Government for bringing the health facility closer to the people. Ms Chibwe, who lives in Chainama near the hospital, said the facility will help them access medical attention easily without having to incur a lot of costs on transport to UTH. She said.
"This is the development that we have been waiting for, health is key to any nation and we are grateful that the facility has been brought close to us."
These developments that are taking place are in line with the Sixth National Development Plan 2011- 2015.
The vision for the health sector is equitable access to quality health care by all by 2030; its goal is to improve the health status of the people in Zambia in order to contribute to socio-economic development.
The ambassador said managing a modern hospital well is not easier than building it and he pledged his country's support to work closely with Zambia to make the hospital fully functional as early as possible.
ends
SINCE President Rupiah Banda assumed power in 2008, Government has been working round the clock to deliver on the promise and three years down the line many infrastructural developments have seen the light of day.
One of the major infrastructure developments the government of President Banda initiated is the Lusaka General Hospital (LGH). The multi-billion kwacha hospital built with the help from the Chinese government was on Monday commissioned by President Banda.
Mr Banda has put the improvement of the health sector top on the agenda and the opening of the Lusaka General Hospital is proof that the health delivery system is getting closer to the people.
Mr Banda commissioned the K48 billion new Lusaka General Hospital with a call on the district health management team to devise new and more effective ways of looking after public infrastructure and appealed to the public to desist from vandalism.
"My only plea to all of you is that you play a serious part in looking after these facilities and guard them jealously. Please play a role in discouraging vandalism, the hospital has been built for you at great cost and you must benefit from its services for a long time to come," said Mr Banda.
The opening of the 150-bed second level hospital is yet another indication of President Banda's desire to preside over an administration that is committed to taking quality and affordable health care as close to the people as possible.
The construction of the hospital is aimed at decongesting the University Teaching Hospital (UTH). Other clinics in Lusaka, such as Matero, Kanyama, Chawama and Chipata, have already been upgraded to mini-hospitals. The Lusaka General Hospital was constructed by China Jiangsu International Economic Cooperation under a grant by the People's Republic of China.
The newly-constructed hospital covers a floor space of 7,500 square metres with 150 sickbeds. Chinese Ambassador to Zambia Zhou Xiao said departments such as internal machine, surgery, gynaecology and Obstetrics, paediatrics, emergency, imaging and radiology will be set up to facilitate comprehensive medical services. Mr Zhou said China has equipped the hospital with 128 categories of modern medical equipment, laboratory facilities and auxiliary installations.
Other equipment include CT scanner, a digital X-ray machine, a coloured ultrasound system and fibre gastro scope.
Mr Zhou said more equipment would be made available to the hospital by China to meet the increasing needs. President Banda's Government has in the last two years built hospitals, health centres, health posts, training schools and houses for medical staff to enhance access to quality health care countrywide.
"My Government is determined to improve the health delivery system in the country so that our vision to provide Zambians with equity of access to cost- effective health care as close to the family as possible is realised. We are doing this by building modern district hospitals throughout the country," Mr Banda said.
The President said the Lusaka General Hospital is a high- tech shining example of the reliable and mutually beneficial relationship Zambia enjoys with the People's Republic of China.
Government is not only building hospitals, but also ensures that the facilities have sufficient drugs and are manned by a professional and motivated workforce in order to ensure that the hospitals have adequate manpower.
Mr Banda said a recruitment drive for manpower has been embarked upon both locally and abroad. For this year alone, Government allocated K52 billion to the Ministry of Health for the recruitment of different categories of health workers, and the process is ongoing.
"We have opened a new medical school at the Copperbelt University to train more medical and dental surgeons. We also hope to increase the intake of students in our institutions by expanding learning facilities and opening new ones," he said.
The introduction of new training programmes such as the direct entry training for midwives and parallel enrolment schemes for clinical officers have led to a significant improvement in the number of personnel in the country.
China has also decided to attach 11 Chinese volunteer doctors to the hospital while the 16th team with another 28 doctors is ready to leave China for Zambia anytime soon.
From 1978 to date, China has made 500 scholarships available to Zambia. 150 have completed their studies while others are still studying medical science in China. Among the 44 students who are going to study on Chinese scholarships this year, 13 of them will major in medicine.
The medical scholarships are aimed at helping Zambia's capacity building in the health sector, which is equally as essential as hospital building.
Mr Banda said the commissioning of the new district hospital in Lusaka is an affirmation of another great achievement Government has recorded for the people of Zambia. He said the new hospital is another demonstration of what Government is accomplishing to improve health service delivery to the people.
In the last two years Government has built hospitals, health centres, health posts, training schools and houses for medical staff to enhance access to quality health care.
All Zambians who appreciate the services being offered at various medical facilities in the country will admire and support the work Government is doing.
"We have been able to plan for the increasing demands by constructing the modern hospital. My Government is also aware that Lusaka faces many other health concerns such as HIV and AIDS, maternal health demands and critical injuries arising from road traffic accidents which will now be ably handled at the new hospital," Mr Banda said.
A Lusaka resident Margarate Chibwe, who witnessed the official opening of the hospital, commended Government for bringing the health facility closer to the people. Ms Chibwe, who lives in Chainama near the hospital, said the facility will help them access medical attention easily without having to incur a lot of costs on transport to UTH. She said.
"This is the development that we have been waiting for, health is key to any nation and we are grateful that the facility has been brought close to us."
These developments that are taking place are in line with the Sixth National Development Plan 2011- 2015.
The vision for the health sector is equitable access to quality health care by all by 2030; its goal is to improve the health status of the people in Zambia in order to contribute to socio-economic development.
The ambassador said managing a modern hospital well is not easier than building it and he pledged his country's support to work closely with Zambia to make the hospital fully functional as early as possible.
ends
Zambia's fight against HIV/AIDS hampered by TB
Violet Mengo
The Daily Mail, Zambia
IT IS NOT ZAMBIA ALONE BUT MANY OTHER COUNTRIES ALSO ARE IN A SIMILAR SITUATION OF DIFFICULTIES WITH TB HIV CO-INFECTION"
Zambia's fight against HIV/AIDS is being hampered by the preventable and curable disease - tuberculosis (TB).
Efforts to address this challenge has resulted in a global meeting scheduled for New York where government, public health and business leaders, heads of UN agencies and advocates will acknowledge HIV/TB as an urgent priority. VIOLET MENGO reports.
THE first ever HIV/TB Global Leaders' Forum, convened by Dr Jorge Sampaio, the UN Secretary-General's Special Envoy to Stop TB, seeks to galvanize leadership at all levels in curbing the scourge.
At this meeting Dr Sampaio is expected to report back to the UN General Assembly High-Level meeting on AIDS which would take place a day after the leaders' forum on the results of the HIV/TB Global Leaders' Forum. It will be a call to action.
This is against a background of calls for bold leadership at all levels to cut the number of deaths from TB among people living with HIV in the world.
With the emergence of drug resistant strains of TB, which are particularly lethal in populations with high rates of HIV infection, HIV/TB has become a global security issue.
It is also believed that drugs, diagnostics and vaccines currently available are not appropriate for people with HIV/TB co-infection. The call is for new tools that work in the presence of co-infection.
HIV and TB are major constraints for socio-economic development and investing in joint TB and HIV/AIDS interventions would strengthen health systems and contribute to the achievement of the Millennium Development Goals on poverty reduction by keeping people healthy and productive.
The leaders' forum provides a platform on which to ensure that HIV/TB prevention and treatment is secure.
It is expected that leaders at the forum will take the opportunity to reaffirm their commitment to addressing this dual threat.
Many countries in the world, and Africa in particular are making impressive gains in treating people living with HIV, but this investment and progress is squandered by TB.
Without proper treatment with anti-TB drugs, approximately 90 per cent of people living with HIV die within two to three months of becoming sick with TB, even if they are receiving anti-retroviral treatment.
Worldwide, nearly a quarter of a million people die from HIV/TB co-infection each year. This dual threat is a barrier to keeping people healthy and productive, and impacts poverty reduction plans and the broader development agenda.
The International Labour Organisation (ILO) reports that the HIV/AIDS epidemic has lowered the growth of gross domestic product (GDP) worldwide by US$25 billion per year.
A number of studies, including one released by the World Bank last month, have also found that the direct and indirect costs of inaction on HIV are far greater than the costs of treatment.
As for TB, a 2007 World Bank research report stated that countries heavily affected by TB could collect at least 9 times their investments in TB control.
In Zambia, TB incidences have greatly increased in the last 10 years. DOTS (Directly Observed Treatment Short Course), the internationally recommended TB control strategy that includes standardised case detection, treatment and patient support that requires consistent drug supply and effective monitoring systems is in place.
Zambia has adopted and implemented DOTS since 2000. Full national DOTS coverage was reportedly achieved at the end of 2006 with an estimated treatment success rate of 90 per cent.
But is it really time to focus on DOTS more intensively?
According to the World Health Organisation (WHO), drug resistant TB is a symptom of poor programme performance.
It is said that if it is hoped to change the outcome and decrease the proportion of drug resistant TB, the DOTS model should to be adapted or its implementation improved. More of the same might only compound the TB drug resistance threat.
Despite the recent DOTS coverage gains in Zambia, many communities in the rural areas are lagging due to a number of reasons.
Rural settings, poor communities and mobile populations, for example are subject to social and economic factors that often lead to incomplete or inappropriate treatment.
In addition, TB diagnosis is difficult in people living with HIV- a growing proportion of people with TB today.
Better strategies to make TB control programmes work more effectively for the most vulnerable and hard to reach communities are also essential to improving treatment adherence and as a consequence reducing drug resistance.
The Ministry of Health 2006 annual report highlights Multi Drug Resistant TB (MDR-TB) as having been encountered in Zambia and its presence in HIV programme.
MoH spokesperson Dr Canisius Banda said the ministry had continued to experience challenges in addressing HIV/TB.
He said the ministry was working on addressing the challenges of HIV/TB with help from partners.
"The challenge of HIV/TB challenges is being felt and efforts to address this problem were being addressed. It is not Zambia alone but many other countries also are in a similar situation of difficulties with co-infection. We are partnering with the private sector to expand service provision," Dr Banda said.
He said concerted efforts from higher levels were the best way of answering the challenge of co-infection in Zambia and the region as a whole.
Dr Banda called for effective TB treatment for those with TB and preventive therapy to those with the disease.
"A six months treatment costs less than US$20 while a preventive drug therapy costs US$2, an amount many Zambians can easily afford. Many people are not keen on prevention," he said.
In Zambia, progress remains slow on the more challenging front of detecting and treating TB among people cared for in HIV treatment settings.
Dr Banda said that 90 percent of people with TB were also HIV positive; he said this was very common in many patients in Zambia.
Zambia's HIV activist and a person living with HIV/AIDS Winstone Zulu urged the Government to help stop TB especially among people living with HIV.
Mr Zulu, who is also a TB Partnership Kochon Winner (2007), said it would be good to see a unified response to the challeng
The Daily Mail, Zambia
IT IS NOT ZAMBIA ALONE BUT MANY OTHER COUNTRIES ALSO ARE IN A SIMILAR SITUATION OF DIFFICULTIES WITH TB HIV CO-INFECTION"
Zambia's fight against HIV/AIDS is being hampered by the preventable and curable disease - tuberculosis (TB).
Efforts to address this challenge has resulted in a global meeting scheduled for New York where government, public health and business leaders, heads of UN agencies and advocates will acknowledge HIV/TB as an urgent priority. VIOLET MENGO reports.
THE first ever HIV/TB Global Leaders' Forum, convened by Dr Jorge Sampaio, the UN Secretary-General's Special Envoy to Stop TB, seeks to galvanize leadership at all levels in curbing the scourge.
At this meeting Dr Sampaio is expected to report back to the UN General Assembly High-Level meeting on AIDS which would take place a day after the leaders' forum on the results of the HIV/TB Global Leaders' Forum. It will be a call to action.
This is against a background of calls for bold leadership at all levels to cut the number of deaths from TB among people living with HIV in the world.
With the emergence of drug resistant strains of TB, which are particularly lethal in populations with high rates of HIV infection, HIV/TB has become a global security issue.
It is also believed that drugs, diagnostics and vaccines currently available are not appropriate for people with HIV/TB co-infection. The call is for new tools that work in the presence of co-infection.
HIV and TB are major constraints for socio-economic development and investing in joint TB and HIV/AIDS interventions would strengthen health systems and contribute to the achievement of the Millennium Development Goals on poverty reduction by keeping people healthy and productive.
The leaders' forum provides a platform on which to ensure that HIV/TB prevention and treatment is secure.
It is expected that leaders at the forum will take the opportunity to reaffirm their commitment to addressing this dual threat.
Many countries in the world, and Africa in particular are making impressive gains in treating people living with HIV, but this investment and progress is squandered by TB.
Without proper treatment with anti-TB drugs, approximately 90 per cent of people living with HIV die within two to three months of becoming sick with TB, even if they are receiving anti-retroviral treatment.
Worldwide, nearly a quarter of a million people die from HIV/TB co-infection each year. This dual threat is a barrier to keeping people healthy and productive, and impacts poverty reduction plans and the broader development agenda.
The International Labour Organisation (ILO) reports that the HIV/AIDS epidemic has lowered the growth of gross domestic product (GDP) worldwide by US$25 billion per year.
A number of studies, including one released by the World Bank last month, have also found that the direct and indirect costs of inaction on HIV are far greater than the costs of treatment.
As for TB, a 2007 World Bank research report stated that countries heavily affected by TB could collect at least 9 times their investments in TB control.
In Zambia, TB incidences have greatly increased in the last 10 years. DOTS (Directly Observed Treatment Short Course), the internationally recommended TB control strategy that includes standardised case detection, treatment and patient support that requires consistent drug supply and effective monitoring systems is in place.
Zambia has adopted and implemented DOTS since 2000. Full national DOTS coverage was reportedly achieved at the end of 2006 with an estimated treatment success rate of 90 per cent.
But is it really time to focus on DOTS more intensively?
According to the World Health Organisation (WHO), drug resistant TB is a symptom of poor programme performance.
It is said that if it is hoped to change the outcome and decrease the proportion of drug resistant TB, the DOTS model should to be adapted or its implementation improved. More of the same might only compound the TB drug resistance threat.
Despite the recent DOTS coverage gains in Zambia, many communities in the rural areas are lagging due to a number of reasons.
Rural settings, poor communities and mobile populations, for example are subject to social and economic factors that often lead to incomplete or inappropriate treatment.
In addition, TB diagnosis is difficult in people living with HIV- a growing proportion of people with TB today.
Better strategies to make TB control programmes work more effectively for the most vulnerable and hard to reach communities are also essential to improving treatment adherence and as a consequence reducing drug resistance.
The Ministry of Health 2006 annual report highlights Multi Drug Resistant TB (MDR-TB) as having been encountered in Zambia and its presence in HIV programme.
MoH spokesperson Dr Canisius Banda said the ministry had continued to experience challenges in addressing HIV/TB.
He said the ministry was working on addressing the challenges of HIV/TB with help from partners.
"The challenge of HIV/TB challenges is being felt and efforts to address this problem were being addressed. It is not Zambia alone but many other countries also are in a similar situation of difficulties with co-infection. We are partnering with the private sector to expand service provision," Dr Banda said.
He said concerted efforts from higher levels were the best way of answering the challenge of co-infection in Zambia and the region as a whole.
Dr Banda called for effective TB treatment for those with TB and preventive therapy to those with the disease.
"A six months treatment costs less than US$20 while a preventive drug therapy costs US$2, an amount many Zambians can easily afford. Many people are not keen on prevention," he said.
In Zambia, progress remains slow on the more challenging front of detecting and treating TB among people cared for in HIV treatment settings.
Dr Banda said that 90 percent of people with TB were also HIV positive; he said this was very common in many patients in Zambia.
Zambia's HIV activist and a person living with HIV/AIDS Winstone Zulu urged the Government to help stop TB especially among people living with HIV.
Mr Zulu, who is also a TB Partnership Kochon Winner (2007), said it would be good to see a unified response to the challeng
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