BANGKOK, July 15 (AFP) - The charisma of Nelson Mandela and the cheque book of Bill Gates joined forces at the world AIDS conference here Thursday to lay assault on tuberculosis, a companion killer disease to HIV.
Mandela, an iconic figure at the global AIDS forum, branded tuberculosis -- of which he himself was once a victim -- a silent slayer in the HIV/AIDS pandemic, while Gates' charity unveiled a 44.7-million-dollar grant to help the search for fighting TB at the grass roots.
"Tuberculosis remains ignored. Today we are calling the world to recognise that we can't fight AIDS unless we take on TB as well," Mandela said at a press conference.
Mandela recalled his own experience with TB during his long imprisonment on Robben Island during South Africa's apartheid years, and his diagnosis with prostate cancer after his release.
In both cases, it had been vital to him to tell his friends and family about his health status and to closely follow the counsel of his doctors.
"In both cases I spoke about it openly, because once people were aware of the facts, they would support me," Mandela said.
Those remarks touched on one of the biggest problems facing the human immunodeficiency virus and TB.
People with HIV are often afraid of prejudice, so refuse to get tested for the virus or tell loved-ones about their status.
And patients with TB often fail to adhere to their drug regimen right to the end after their symptoms disappear.
They thus expose themselves to the risk that they will fall sick again and help to breed resistant strains of the microbe that are now a mighty problem.
Of the 38 million people around the world infected with HIV, 14 million are co-infected with TB, a condition that accelerates the progress towards full-blown acquired immune deficiency syndrome (AIDS).
People whose immune system is weakened by HIV very often become vulnerable to TB, especially if they live in overcrowded slums or prisons. Seventy percent of coinfections are in sub-Saharan Africa.
Of the estimated 1.6 million annual deaths from TB, one quarter occur among people with HIV/AIDS. And of the roughly three million deaths from AIDS last year, a third was caused by TB.
The grant announced by the Bill and Melinda Gates Foundation will support the work of a US-led organisation to explore ways of controlling TB in places where there are also high rates of HIV infection.
It is called CREATE -- the Consortium to Respond Effectively to the AIDS-TB Epidemic -- with the lead role taken by the Johns Hopkins Center for Tuberculosis Research in the US, backed by researchers and health-policy experts from Africa, South America and Europe.
"We've seen a devastating resurgence of TB in developing countries hit hard by HIV/AIDS, and to control it, it is essential that creative new strategies like CREATE is pursuing are identified and quickly put into practice," said Helen Gayle, director of the Foundation's AIDS and TB programme.
Developing countries already have a well-known strategy for combating TB.
DOTS -- directly observed therapy short course -- requires careworkers to monitor carefully that the patient takes a short course of powerful antibiotics all the way through to the end, ensuring that the TB germs are wiped out.
But DOTS relies on patients seeking treatment themselves and targets only those with active TB, not with latent infection.
Overall two billion people -- one third of the world's population -- have the TB microbe but are not sick or aware of the symptoms.
CREATE said it would use the 44.7-million dollar grant to carry out three projects among schools in Zambia, among gold miners in South Africa and HIV-positive patients in Rio de Janeiro, Brazil.
The goal in Zambia is to explore ways of helping people recognise active TB cases; in South Africa and Brazil researchers will test the cost and effectiveness of a treatment programme called isoniazid preventive therapy.
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