From 22-27 July, the XIX International AIDS Conference is being held in Washington, DC, with an expected 20,000 delegates from nearly 200 countries in attendance. Convened by the International AIDS Society, this six-day meeting will bring together leaders in the fight against HIV to “translate recent momentous scientific advances into action that will address means to end the epidemic, within the current context of significant global economic challenges.” Daily highlights and a live webcast are available at the conference website.
In honor of the event, below is one of a series of blogs from our MCHIP experts in HIV and infectious diseases discussing the Program’s work to “turn the tide” on this pandemic. Other blogs in this series are:
As a Program that aims to improve maternal and child health around the world, we at MCHIP are keenly aware of the need to integrate health services wherever possible in an effort to expand our reach and meet the comprehensive needs of individual clients and patients. In Malawi— one of the countries where we address tuberculosis (TB)—this means increasing TB case finding within the context of focused antenatal care (FANC) to serve as many women and their families as possible. And because TB is the leading cause of death among people living with HIV/AIDS, our approach to both of these diseases must be coordinated.
In 2010, there were an estimated 33,000 TB cases among a population of approximately 15 million in Malawi—or a rate of 219 cases per 100,000 population. Moreover, 63% of Malawians diagnosed with TB are co-infected with HIV, and there is an estimated adult HIV population prevalence of 11%. However, despite unprecedented resources utilized to combat these diseases, the global response to TB and HIV has not adequately addressed the needs of pregnant women, stressing prevention of mother-to-child transmission (PMTCT) rather than comprehensive maternal care for mothers-to-be.
By contrast, MCHIP’s approach emphasizes all-inclusive care of women through integrated FANC, keeping mothers alive and eliminating new HIV infections amongst children and reducing the growing number of orphans due to preventable, treatable diseases. This includes integrating intensified case finding for TB into FANC in countries with high incidence of the disease, and ensuring that nurses and midwives in training graduate with the skills they need to care for women with HIV and TB.
MCHIP partner Jhpiego developed the FANC basic job aid and later, under the USAID-funded TB Care II consortium, also led the development of the FANC fundal height tape measure and “FANC +” job aid to facilitate the integration of TB/HIV diagnosis, care and treatment into FANC. The tape measures are uniquely designed to include key integration messages about what a healthcare provider should ask at each visit during the four antenatal care visits. In addition to Malawi, the tape measures have been distributed to Rwanda, Nigeria, Angola, Tanzania, Ghana and Liberia. In Ghana, Nigeria, and Liberia they are going to be used to strengthen the skills of educators and new graduates of nursing and midwifery educational institutions.
HIV and TB are two of the major public health challenges undermining development in the poorest countries in the world, particularly in sub-Saharan Africa. MCHIP has been instrumental in assisting Ministries of Health and institutions of higher education to equip health care providers, those who educate them, as well as those soon to be deployed with the skills they need to prevent, diagnose, treat, care and support communities affected by HIV and TB. Ultimately, we aim to reduce HIV incidence among women, children and men, and to ensure that people living with HIV and TB are promptly diagnosed and linked to high-quality care and treatment services.
As we eagerly await the start of the International AIDS Society conference this month in Washington, DC, we reflect on this year’s theme: Turning the Tide Together. Addressing TB and HIV in concert is surely an integral part of turning the tide and of scaling up interventions to reach our shared goal—zero new infections, zero discrimination, and zero TB or AIDS-related deaths.
Sheena Currie, MCHIP Senior Maternal Health Adviser
Stacie Stender, MCHIP Technical Advisor in TB/HIV/Infectious Diseases