"We cannot win the battle against AIDS if we do not also fight TB. TB is too often a death sentence for people with AIDS. It does not have to be this way."
- Nelson Mandela, Former President of South Africa
MEDIA ADVISORY
During the 15th International AIDS Society conference (July 11 - 15, 2004), the untold story behind the AIDS crisis is the escalating twin epidemic of tuberculosis (TB) and HIV. AIDS is now spreading fastest in Asia and Eastern Europe – the same regions with the highest levels of TB incidence – and TB is the leading killer of those with AIDS and HIV worldwide. Development of faster-acting TB drugs, that are antiretroviral (ARV) compatible by design, is crucial to combat both epidemics.
TB and HIV are mutually reinforcing, with a reservoir of 2 billion latent TB cases fueling both epidemics. HIV increases the risk of progression from latent TB to its active, contagious form by a factor of 30-50. TB in turn accelerates the progression of HIV with fatal results: in Africa, a person with AIDS who contracts active TB has an estimated survival time of just five weeks.
While drugs that treat TB exist, the best and newest of these – the rifamycin family – has dangerous drug-drug interactions with ARVs. Introduced in the 1960s well before the AIDS era, most rifamycins have negative interactions with ARVs that are metabolized by the cytochrome P-450 enzyme system, such as the protease inhibitors. This interaction presents a worrying treatment dilemma: which disease to treat? Suspending HIV treatment in favor of complex TB treatment is risky: TB therapy requires at least 6 to 9 months, and HIV+ TB patients are much less likely to survive the full course.
Today’s outdated TB drugs reflect the lack of robust pipelines for diseases of poverty, but new drugs are on their way, thanks to an innovative public-private partnership, the Global Alliance for TB Drug Development (TB Alliance). With a growing portfolio of drug candidates, the Alliance’s goal is to deliver new anti-TB drugs that are affordable, compatible with ARVs, and accessible in endemic countries. The TB Alliance determines the exact profile of its new drugs by consulting global health organizations, including the Global Fund to Fight AIDS, TB and Malaria and the World Health Organization, to ensure their prompt delivery, adoption and use.
The TB Alliance can address the worsening TB-HIV/AIDS crisis and specifically, how new TB drugs will be an integral part of the solution to extend lives and improve both HIV care and prevention. The following representatives are available for comment:
Dr. Lee Reichman, Executive Director of the U.S. National Tuberculosis Center, was one of the first doctors to identify TB-HIV co-infection in the U.S.. Dr. Reichman is the President of TB Alliance Stakeholders and author of “Timebomb: The Global Epidemic of Multi-Drug Resistant Tuberculosis.”
Dr. Ann Ginsberg, Head of Clinical Development at the TB Alliance
Dr. Charles Yu, Philippines Coalition Against TB (PHILCAT)