Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date.
San Francisco Chronicle - July 16, 2004
Sabin Russell, srussell@sfchronicle.com.
It was with that experience in mind that the iconic South African leader, now 85 years old, slowly walked into a crowded news conference at the 15th International AIDS conference Thursday to endorse a new initiative to battle the dual epidemics of tuberculosis and HIV.
"We cannot win the battle against AIDS if we do not also fight TB," Mandela said. "TB is too often a death sentence for people with AIDS."
An ancient scourge that is one of the world's leading killers, tuberculosis is now the leading cause of death in Africa and much of the developing world among people with AIDS. Their broken immune systems make them vulnerable to the TB bacterium, which attacks and scars lung tissue.
In sub-Saharan Africa, two out of three tuberculosis patients are also infected with HIV.
"TB and HIV form a lethal combination, each amplifying each other's progress," said Dr. Richard Chaisson, a TB specialist at Johns Hopkins University. "It is possible to treat both diseases at once."
Chaisson is also principal scientist for a new tuberculosis research consortium awarded a $45 million grant Thursday from the Bill & Melinda Gates Foundation. The foundation also made a surprise announcement Thursday that it was donating another $50 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria, the independent AIDS relief agency set up by the United Nations and strongly supported by Mandela. The Gates Foundation had previously donated $200 million to set up the Global Fund, helping it get off the ground.
The group Chaisson is working with will conduct research on new ways of delivering old -- but effective -- interventions to prevent and treat TB. That includes providing a six- to nine-month course of an inexpensive antibiotic, isoniazid, to people who test positive for tuberculosis but do not have an active infection. The drug can prevent a latent case from becoming a lethal infection.
A second program will expand efforts to test for active tuberculosis in populations with high levels of latent infection. Testing can bring the people with active cases in for treatment, so they can recover -- as Nelson Mandela did -- from the infection and be less likely to transmit the disease to others.
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