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Health Surveillance and Disease Management / Communicable Diseases / Tuberculosis

Interim Policy on Collaborative TB/HIV Activities

(World Health Organization Stop TB Department and Department of HIV/AIDS, 2004)

TB/HIV Surveillance

WHO E-Book (20 pp, PDF)
1. Introduction
1.1. Rationale
1.2. Purpose
1.3. Target audience
2. Policy formulation process
3. Goal and objectives of collaborative TB/HIV activities
4. Recommended collaborative TB/HIV activities

A. Establish the mechanisms for collaboration
B. Decrease the burden of tuberculosis in people living with HIV/AIDS
C. Decrease the burden of HIV in tuberculosis patients
5. Thresholds for starting recommended collaborative TB/HIV activities
6. Targets for collaborative TB/HIV activities
7. References


PAHO TB/HIV Workshops: 2004 | 2003


Rationale | Purpose | Target Audience

Rationale: The human immunodeficiency virus (HIV) pandemic presents a massive challenge to the control of tuberculosis (TB) at all levels. Tuberculosis is also one of the most common causes of morbidity and one of the leading causes of mortality in people living with HIV/AIDS (PLWHA). This document will assist policy-makers to understand what should be done to decrease the joint burden of tuberculosis and HIV. It is designed to be used in conjunction with the Strategic Framework to Decrease the Burden of TB/HIV that addresses what could be done and the Guidelines for Implementing Collaborative TB and HIV Programme activities that address how these things could be done. It also complements the guidelines for monitoring and evaluating collaborative TB/HIV activities and the guidelines for HIV surveillance among tuberculosis patients.

Purpose: This policy responds to a demand from countries for immediate guidance on which collaborative TB/HIV activities to implement and under what circumstances. It is complementary to and in synergy with the established core activities of tuberculosis and HIV/AIDS prevention and control programs. Implementing the DOTS strategy is the core activity for tuberculosis control. Similarly, infection and disease prevention and health promotion activities and the provision of treatment and care form the basis for HIV/AIDS control. This policy does not call for the institution of a new specialist or independent disease-control program. Rather, it promotes enhanced collaboration between tuberculosis and HIV/AIDS programs in the provision of a continuum of quality care at service-delivery level for people with, or at risk of, tuberculosis and people living with HIV/AIDS.
While there is good evidence for the cost effectiveness of the DOTS strategy and several HIV prevention measures, the evidence for collaborative TB/HIV activities is limited and is still being generated in different settings. Existing evidence from randomized controlled trials, non-randomized trials and other analytical and descriptive observational studies, operational research and expert opinion based on sound clinical and field experience was used for this interim policy document. It is a rolling policy, which will be continuously updated to reflect new evidence and best practices.

Target Audience: This document is intended for decision-makers in the field of health, for tuberculosis and HIV/AIDS program managers working at all levels in the health sector, as well as donors, development agencies and nongovernmental organizations supporting tuberculosis and HIV/AIDS programs. The recommendations made in this document also have important implications for the strategic directions and activities of other ministries.

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