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Health Surveillance and Disease Prevention and Control / Communicable Diseases / Tuberculosis

Fifth Regional Meeting on TB/HIV Collaborative Activities

(San José, Costa Rica, 6–7 November 2008)


- Meeting Objectives
- Presentations (Spanish & English)
- Links
- Agenda (Spanish)
- Working Group Guide (Spanish)
- Final Report (Spanish, with chapter headings translated)

Introduction: The growing epidemic of HIV infection represents a great challenge for TB control at all levels. In addition, TB constitutes one of the most frequent causes of morbidity and mortality among people who live with HIV. Thus, TB/HIV coinfection represents a serious threat to the attainment of the programming and clinical objectives of both TB and HIV programs. Currently, there is an established policy for TB/HIV collaborative activities that helps guide which actions to take to relieve the simultaneous burden of tuberculosis and HIV.

Meeting Objectives

  • Confirm the progress made in implementing TB/HIV collaborative activities in the countries and share experiences.
  • Review the most recent advances in TB/HIV, with emphasis on the "three I's" (Intensified case finding / ICF, Isoniazid Preventive Therapy / IPT, and Tuberculosis Infection Control / IC).
  • Program TB/HIV implementation activities.

Participants: Heads of National TB and of HIV Programs from 20 countries of the Region, accompanied by the PAHO Focal Points in the countries and PAHO Regional TB and HIV Program teams.

Central Focus: Emphasis was placed on the importance of establishing joint agendas for interprogrammatic work as an effective tool to diminish the HIV/AIDS burden among patients with TB and the TB burden among people infected with HIV. It was shown that, although there has been great progress in the implementation of TB/HIV collaborative activities, there are still areas that need to be strengthened, such as joint evaluation of TB/HIV activities, implementation of preventive therapy with cotrimoxazole for TB patients with HIV, and surveillance of the prevalence of HIV in patients with TB.

The Three I's: It was recognized that the three I's constitute a key priority in caring for people with HIV and present a great opportunity to diminish morbidity, mortality and t TB transmission among people with HIV. In this regard, it becomes necessary to significantly intensify the search for TB among people with HIV, in addition to increasing the implementation of preventive therapy with isoniazide and to make progress towards infection control in health facilities.

Key Points: Noteworthy were the strengths that the countries of the Region have to achieve this purpose, as well as the challenges and weaknesses that should be overcome in order to address this double epidemic through combined efforts. The countries in attendance made commitments to move ahead with TB/HIV collaborative activities in the following eight months, up to the time when the next Regional meeting will be held.

Intersectoral Call for Action: An appeal was made to civil society, affected persons, and activists to get involved in TB/HIV collaborative activities of collaboration. An agreement was made for TB/HIV coinfection to be a made priority in both programs (TB and HIV) in the countries.

Presentations (PPT PDF)

In English and Spanish
- Meeting Objectives | Spanish
- Current Situation and Progress in the.Implementation of TB/HIV Collaborative Activities Worldwide | Spanish
- Grant Management Solutions: Technical Support to Global Fund Grants (English only)
- Multidrug-Resistant and.Extensively Drug Resistant Tuberculosis in the Era of HIV | Spanish
- Global Progress Report on the Three I's |  Spanish
- Guyana: TB/HIV Collaboration | Spanish

In Spanish only (titles translated for user orientation)
- Avances en la implementación de las actividades de colaboración TB/VIH [Progress in the Implementation of TB/HIV Collaborative Activities]
- Situación de la TB/VIH en las Américas [TB/HIV Situation in the Americas]
- Fondo Mundial: Una oportunidad para financiar actividades de colaboración TB/VIH [Global Fund: An Opportunity for Financing TB/HIV Collaborative Activities]
- Aportes de la búsqueda de casos de TB en pacientes con VIH [Notes on Case-Finding of TB Patients with HIV]
- Actualización en Terapia Preventiva con Isoniacida (TPI) [Update on Isoniazid Preventive Therapy (IPT)]
- Control de infecciones desde la perspectiva VIH [Infection Control from an HIV Perspective]

Country Presentations (all in Spanish except for Guyana)
- Brazil: Respuesta nacional a la co-infección VIH/TB [National Response to TB/HIV Coinfection]
- Costa Rica: Actividades de colaboración TB/VIH [TB/HIV Collaborative Activities]
- Dominican Republic
- Ecuador: Actividades de colaboración TB/VIH [TB/HIV Collaborative Activities]
- El Salvador: Control de infecciones [Infection Control] | Pasos concretos [Concrete Steps]
- Guyana: Colaboración TB/VIH [TB/HIV Collaboration] | English
- Honduras: Grupo de trabajo TB/VIH [TB/HIV Working Group]
- Mexico: Actividades de colaboración TB-VIH/SIDA [TB-HIV/AIDS Collaborative Activities]
- Nicaragua: Avances en la implementación de actividades de colaboración TB/VIH [Progress in the Implementation of TB/HIV Collaborative Activities]
- Panama
- Paraguay
- Peru: Actividades conjuntas TB/VIH [TB/HIV Joint Activities]
- Uruguay: Compromisos [Commitments]
- Venezuela: TB/VIH: Programación conjunta 2008–2009 [TB/HIV Joint Programming 2008–2009]

Final Report (in Spanish, PDF, 31 pp, 1.3 Mb; chapter headings translated below for user orientation)

Acronyms |  Summary (translated to right) |
Background |  Opening |  Objectives |
Session of 6 November
- Implementing TB/HIV Collaborative Activities
Session of 7 November
- The Three I's (Intensified case finding / ICF, Isoniazid Preventive Therapy / IPT, and Tuberculosis Infection Control / IC)
- Roundtable Discussion on the Three I's
- Other Important Aspects of TB/HIV Coinfection
- Experience-Sharing Fair
- Planning TB/HIV Collaborative Activities in the Countries: Country Committments

1. Venezuela
2. Uruguay
3. Dominican Republic
4. Peru
5. Paraguay
6. Panama
7. Nicaragua
8. Mexico
9. Honduras
10. Haiti

11. Guyana
12. Guatemala
13. El Salvador
14. Ecuador
15. Cuba
16. Costa Rica
17. Chile
18. Colombia
19. Brazil
20. Argentina

Conclusions | Recommendations
Annex 1: Agenda
Annex 2: Meeting Evaluation
Annex 3: List of Participants

PAHO Links
- Guide for TB/HIV Counselling and Testing in Tuberculosis Programs
- Workshops on TB/HIV:
8/2006 |  | 4/2006 | 2004 | 2003
- Guide for Tuberculosis Control in Populations Deprived of Liberty in Latin America and the Caribbean
- Workshops on TB in prisons:
2008 | 2006 | 2004 | 2003
Tuberculosis Page |  AIDS Page

WHO Links
Joint HIV/Tuberculosis Interventions

Stop TB Partnership

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