HIV infection and tuberculosis in South Africa: an urgent need to escalate the public health response.
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Date
2009
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
One of the greatest challenges facing post-apartheid South Africa is the control of the concomitant HIV and
tuberculosis epidemics. HIV continues to spread relentlessly, and tuberculosis has been declared a national emergency.
In 2007, South Africa, with 0·7% of the world’s population, had 17% of the global burden of HIV infection, and one
of the world’s worst tuberculosis epidemics, compounded by rising drug resistance and HIV co-infection. Until
recently, the South African Government’s response to these diseases has been marked by denial, lack of political will,
and poor implementation of policies and programmes. Nonetheless, there have been notable achievements in disease
management, including substantial improvements in access to condoms, expansion of tuberculosis control efforts,
and scale-up of free antiretroviral therapy (ART). Care for acutely ill AIDS patients and long-term provision of ART
are two issues that dominate medical practice and the health-care system. Decisive action is needed to implement
evidence-based priorities for the control of the HIV and tuberculosis epidemics. By use of the framework of the
Strategic Plans for South Africa for tuberculosis and HIV/AIDS, we provide prioritised four-step approaches for
tuberculosis control, HIV prevention, and HIV treatment. Strong leadership, political will, social mobilisation,
adequate human and financial resources, and sustainable development of health-care services are needed for
successful implementation of these approaches.
Description
Keywords
HIV infections--Government policy--South Africa., AIDS (Disease)--Government policy--South Africa., Tuberculosis--Government policy--South Africa., Tuberculosis--Prevention., Tuberculosis--Control--South Africa., HIV infections--Prevention and control--South Africa.
Citation
Abdool Karim, S.S., Churchyard, G.J., Abdool Karim, Q., Lawn, S.D. 2009. HIV infection and tuberculosis in South Africa: an urgent need to escalate the public health response. Lancet 374, pp. 921-933.