AEGiS-15IAC: Resources required for collaborative TB and HIV/AIDS programme activities in the context of the World Health Organization's "3 by 5" initiative.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Resources required for collaborative TB and HIV/AIDS programme activities in the context of the World Health Organization's "3 by 5" initiative.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. TuOrD1209)

Floyd K, Kumaranayake L, Getahun H, Nunn P
World Health Organization, Geneva, Switzerland

BACKGROUND: In 2003, the World Health Organization (WHO) set a target that 3 million HIV+ people in developing countries should be enrolled on antiretrovial treatment (ART) by 2005 (the "3 by 5" initiative). Many HIV+ tuberculosis (TB) patients meet the criteria for enrolment on ART. TB programmes can make an important contribution to achievement of the target if they have the resources required to implement WHO policy recommendations on collaborative TB and HIV programme activities.

METHODS: We assessed the costs of implementing the interventions recommended in WHO's "Interim Policy on Collaborative TBHIV activities" in the 34 countries included in the "3 by 5" initiative. Annual costs were estimated by multiplying unit costs by the number of people eligible for each intervention. Sources of data included pilot TBHIV projects, a costing model developed for the "3 by 5" initiative, TB notification data, and estimates of HIV prevalence among TB patients.

RESULTS: Approximately US$250 million is required each year. The biggest costs are ART for TB patients (about 50% of total costs) and coordination at different administrative levels (about 30% of total costs). Four interventions aimed at reducing the burden of HIV among TB patients (HIV counselling and testing for TB patients, HIV prevention for TB patients, palliative care for TB patients, and treatment of opportunistic infections during TB treatment) cost US$10-20 million each. Other interventions, including those aimed at reducing the burden of TB in HIV+ individuals (e.g. isoniazid preventive therapy, intensified TB case finding) and cotrimoxazole prophylaxis for HIV+ TB patients, cost< US$5 million each. South Africa, Zimbabwe, Ethiopia, Tanzania and Kenya had the highest costs.

CONCLUSIONS: Implementation of TBHIV collaborative activities in the context of ambitious goals for improved access to ART requires about US$0.25 billion per year. This is large compared to existing spending by TB programmes but small as compared to the total resources required to address the HIV/AIDS epidemic.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Seropositivity, World Health Organization, Tuberculosis, Prevalence, Health Resources, Developing Countries, Disease Outbreaks, Isoniazid, Ethiopia, Kenya, Tanzania, South Africa, Zimbabwe, Humans, therapy

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