SENIOR UN OFFICIALS APPLAUD RWANDAN EFFORTS TO STOP THE SPREAD OF HIV, TB

Senior United Nations officials today praised Rwanda for successfully integrating the treatment of patients suffering from HIV and tuberculosis after witnessing first-hand the delivery of health services in the African nation.

"It is gratifying to be at this clinic, which has intensified TB case finding in people living with HIV through TB screening and transferring confirmed cases to a TB clinic," said the Secretary-General's Special Envoy to Stop TB Jorge Sampaio, referring to a visit to the Socio-Medical Centre in Biryogo.

"In addition patients who enrol at the health centre with tuberculosis are also tested for HIV and those found to be HIV-positive are given integrated care and support," noted Dr. Sampaio, adding that the programme "reflects Rwanda's impressive progress nationwide on coordinating TB and HIV services."

The head of the Joint United Nations Programme on HIV/AIDS (UNAIDS) spotlighted the progress Rwanda has made in easing the impact of TB and HIV co-infection through better collaboration and the use of innovative diagnostic technology.

"I am pleased to see that Rwanda is leading Africa and the world in taking an integrated approach to dealing with the interlinked epidemics of TB and HIV," said UNAIDS Executive Director Michel Sidibé.

"Rwanda's bold leadership is achieving impressive results that show the rest of Africa what can be achieved," said Mr. Sidibé.

On a later visit to Rwanda's National Reference Laboratory in Kigali, Dr. Sampaio and Mr. Sidibé congratulated staff and recognized their critical role in reducing deaths from TB among people living with HIV, while underscoring the need for much greater investment in strengthening laboratory services not least for a faster, simpler and more accurate TB test.

TB diagnosis requires visualization under a microscope of the bacteria, obtained via sputum samples, which cause the disease. But few bacteria are present in the coughed-up phlegm of many HIV sufferers, leading to a missed diagnosis in many cases.

The sensitivity of a TB diagnosis can be improved by incubating the samples to multiply the TB bacteria which can take weeks or months to grow using conventional methods. In an effort to increase speed and accuracy of TB diagnosis, fast liquid culture (MGIT) is slated to be rolled out soon in Rwanda. The National Reference Laboratory is also studying more efficient microscopes and staining techniques to shorten the time-lag in TB diagnosis.

Earlier this week, Mr. Sidibé addressed the 59th session of the World Health Organization's (WHO) Regional Committee for Africa in Kigali, where he stressed the urgent need stop new HIV infections and called for a sea-change approach to prevent sexual transmission of HIV. "Prevention must become our watchword, the banner we raise in this critical stage of the response."
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UNAIDS CHIEF WELCOMES PLAN TO SLASH PRICES OF ESSENTIAL MEDICINES

A top United Nations official has hailed agreements reached by the Clinton Foundation with pharmaceutical companies Pfizer and Matrix to reduce the prices of antiretroviral drugs for people living with AIDS and tuberculosis (TB).

"The reduction of prices of second line antiretroviral drugs will saves lives," said Michel Sidibé, Executive Director of the Joint UN Programme on HIV/AIDS (UNAIDS). "These agreements will help improve the sustainability of national treatment programmes over the long term."

Second line antiretroviral drugs are necessary when people living with HIV – currently an estimated 33 million people worldwide – fail to respond to standard treatment regimens.

At the end of last year, an estimated 5 per cent of the 4 million people on antiretroviral treatment required second line drugs, according to UNAIDS, which added that the need for these drugs is expected to rise in the coming years.

The agency noted that the agreement with Matrix to make available three second line drugs in a single package will also contribute to the ease of delivery and help increase treatment adherence.

Meanwhile, the agreement with Pfizer will enable people to seek treatment for TB – a leading cause of death for those living with AIDS – without interrupting their second line treatment.

"People living with HIV should not have to choose between TB and AIDS treatment," said Mr Sidibé. "We have to stop people living with HIV from dying of TB."
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UN-BACKED FUND REACHES OVER 2 MILLION PEOPLE WORLDWIDE WITH AIDS TREATMENT

More than 2 million people living with HIV have been reached with life-saving treatment thanks to the United Nations-backed Global Fund to Fight AIDS, Tuberculosis and Malaria, marking a 30 per cent jump from last year.

Results released today show that on top of the 2.3 million people receiving anti-retroviral medicines for AIDS, Global Fund-backed schemes have also provided 5.4 million people with effective treatment for TB, the leading cause of death among HIV-infected people.

Further, the Fund reported success in the fight against malaria, with 88 million insecticide-treated bednets delivered to families, up from 59 million nets last year.

"In less than eight years, the Global Fund has gone from a concept to a driver of change," said Executive Director Michel Kazatchkine. "When we first began our work in 2002, few people in developing countries were being treated for AIDS or tuberculosis. Malaria was a neglected disease. Many countries simply did not have the resources to fight these diseases effectively."

But now, "the story is changing dramatically," he said, adding that while greater efforts are needed, "real progress" against the diseases has been made.

The information released today combined data from Global Fund-supported initiatives in 140 countries, and showed, among other things, that nearly 80 million people have been reached by HIV counselling and testing, almost 4 million AIDS orphans and vulnerable children have been provided with basic care and support, and 1.4 billion condoms have been distributed worldwide.
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UN-BACKED FORUM COMMITS TO GREATER ACTION, FUNDING TO FIGHT DRUG-RESISTANT TB

Health ministers from countries suffering the highest burden of drug-resistant tuberculosis cases have agreed to a series of measures aimed at accelerating efforts to stop and reverse the global epidemic, at a United Nations-backed meeting in China.

Representatives of 27 countries with a high incidence of multi-drug resistant TB (MDR-TB) are meeting in Beijing for a three-day conference organized by the UN World Health Organization (WHO), China's Ministry of Health and the Bill and Melinda Gates Foundation to secure funding and action to combat the spread of MDR-TB and extensively drug-resistant TB (XDR-TB).

Delegates, including Chinese Vice-Premier Li Keqiang and Bill Gates, kicked off the gathering yesterday, with WHO Director General Margaret Chan stressing that preventing and managing drug-resistant strains of TB was a health imperative for the whole world.

"We need high-level political attention because national TB programmes cannot by themselves manage these new threats. The problem has become too great," said Ms. Chan.

Only three per cent of the estimated new 500,000 multi-drug resistant TB (MDR-TB) cases each year are known to be receiving treatment according to WHO guidelines. Four countries represented at the meeting – China, India, Russia and South Africa, who account for 60 per cent of the world's MDR-TB – have increased their financing to back measures controlling the disease.

Participants also called for measures such as moving towards universal access to M/XDR-TB diagnosis and treatment by 2015, ensuring a sufficient supply of high-quality anti-TB drugs, the development of a comprehensive M/XDR-TB management and care framework, and the implementation of airborne infection control policies among others.

In addition, they pledged to raise the estimated $15 billion needed to finance the TB and M/XDR-TB response through to 2015, and called for increased investment in the research and development of new TB diagnostics, drugs and vaccines.

A report released by WHO last week noted that the total number of new TB cases had stabilized at 9.27 million in 2007 from 9.24 million in 2006. Rates reached their peak at 142 cases per 100,000 people in 2004, but decreased to 137 per 100,000 people in 2007.

The new WHO study also revealed that one-quarter of all TB deaths are HIV-related, twice as many as previous recognized. In 2007, 1.37 million people living with HIV fell ill to TB.TB is an infectious bacterial disease most commonly affecting the lungs, which is transmitted through droplets from the throat and lungs of people with the active respiratory illness. The symptoms of active TB are coughing, sometimes with sputum or blood, chest pains, weakness, weight loss, fever and night sweats, which are treatable with a six-month course of antibiotics.
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UN-BACKED FUND NEEDS ADDITIONAL $4 BILLION TO FUND AIDS, TB AND MALARIA EFFORTS

The question of how to fill an estimated $4 billion funding gap in the United Nations-backed initiative that helps countries fight AIDS, tuberculosis and malaria needs to be urgently addressed, donors at a meeting in the Spanish city of Cáceres stressed today, as they wrapped up a review of resource needs.

The Global Fund to Fight AIDS, TB and Malaria – which helps finance national AIDS programmes – estimates that donor funding for the period 2008-2010 stands at $9.5 billion, $4 billion short of the expected demand of at least $13.5 billion.

"In view of the funding gap and the impact of a global economic crisis on the developing world, the Global Fund looks forward to how leaders of G-20 [Group of 20 most industrialized] countries address this situation at their summit in London on 2 April," said Michel Kazatchkine, the Global Fund's Executive Director.

He added that the Group of Eight (G-8) leaders will also address the same challenge when they meet in La Maddalena, Italy, in July.

Delegates gathered in Spain for the two-day Mid-Term Review meeting of the Global Fund's Second Voluntary Replenishment process said much of the additional resources needed by the Fund would have to come from donors who have committed to increasing their official development assistance (ODA) budgets in order to meet development financing targets set at a international conference in Monterrey in 2002.

The participants, representing 28 donor countries and foundations, also called on the Global Fund to step up efforts to seek new government donors and attract more private sector contributions, according to a news release issued by the Fund.

Several donors indicated that they would soon consider making additional contributions in response to the success achieved by Global Fund programmes. The last two years have seen reductions in mortality in a number of countries for AIDS and malaria, and a continued fall in global TB prevalence that was first noted in 2004.

"We are now affecting the course of these three epidemics. In the case of malaria, in particular, we are on a trajectory to achieve universal access to bed nets by 2011 and have reason to be hopeful the Millennium Development Goal for malaria can actually be reached," said Mr. Kazatchkine, referring to one of several development targets set by world leaders in 2000.

He added that steps were being taken to ensure efficiency gains in the Fund's grants and in the Secretariat in areas such as travel, telecommunications and corporate procurement of goods and services.
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TOP UN OFFICIAL CALLS FOR FULLY FUNDING FIGHT AGAINST AIDS, TB AND MALARIA

The Global Fund to Fight AIDS, Tuberculosis and Malaria must be fully funded if countries are to achieve the goal of universal access to HIV prevention, treatment, care and support, the head of the United Nations agency tasked with coordinating the AIDS response has stressed.

Michel Sidibé, Executive Director of the Joint UN Programme on HIV/AIDS (UNAIDS), told donors and partners gathered in the Spanish city of Cáceres for the Mid-Term Review meeting of the Global Fund's Second Voluntary Replenishment process that many countries rely on Fund to finance their national AIDS programmes.

"Countries need predictable financing so that they can focus their efforts on achieving their universal access goals. That is why the Global Fund must be fully funded," he told the meeting, which concludes tomorrow.

The Fund says that donor funding for the period 2008-2010 stands at $9.5 billion – $4 billion short of the expected demand of at least $13.5 billion.

Despite the current global economic downturn, Mr. Sidibé stressed the necessity of investing in delivering HIV services to the millions of people worldwide who are in need.

"We cannot let the economic crisis paralyze us. Stimulus packages and economic adjustments should be made with a human face in mind. A mother should not have to choose between continuing AIDS treatment and feeding her children. We cannot let down the 4 million people on treatment and millions more in need today," he stated.

In a video message to the meeting, Secretary-General Ban Ki-moon called for continued support to the Global Fund, which was established in 2002 by the international community to ensure sufficient funding to combat three deadly diseases.

"The Global Fund is helping countries to set ambitious targets. It is helping them to achieve concrete results. And it is giving affected populations a real voice in programmes and policies that affect them. I urge you to ensure it is fully funded," he said.

The Fund's voluntary replenishment process was established in 2004 to ensure predictable and sustainable funding, and offers an important forum for donors to exchange views and expectations and to enable them to better plan their financial commitments.
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BAN CALLS FUNDING GLOBAL FIGHT AGAINST AIDS, TB, MALARIA ‘SMART INVESTMENT’

In this time of economic turmoil, putting money behind the fight against the AIDS, tuberculosis and malaria epidemics is a "smart investment," Secretary-General Ban Ki-moon said today, as he urged donors to fund United Nations-backed efforts to stop the spread of the deadly diseases.

"Across Africa, AIDS threatens to reduce GDP [gross domestic product] by up to 2.6 per cent," warned Mr. Ban in a video message to the mid-term review meeting of the second voluntary replenishment process of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Mr. Ban noted that since 2001 the Global Fund has committed over $10 billion to health programmes in 140 countries, "helping to keep parents, workers and teachers alive and productive."

Programmes supported by the Fund have helped delay the onset of AIDS in 2 million HIV-positive people, detected and treated 4.6 million cases of TB, delivered 70 million insecticide-treated bed nets and administered 74 million malaria drug treatments.

"It has been a success. The Global Fund has saved millions of lives. It is important that we replenish it," Mr. Ban told the meeting in Cacares, Spain.

Pointing to the $4 billion the Global Fund needs to meet its 2010 targets, Mr. Ban said, "I say to you that spending on AIDS, TB and malaria is a smart investment. It is a true recovery package."

According to the Secretary-General, TB costs the world's poorest communities $16 billion a year, whereas containing it will only cost $4.2 billion a year. Similarly, malaria costs Africa $12 billion a year when just $3.4 billion dollars will pay for prevention and treatment.

Mr. Ban called on the international community to honour their commitments made at the Group of Eight (G-8) Gleneagles Summit in 2005 to fully fund all credible plans.
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UNAIDS CHIEF VISITS BRAZIL TO PROMOTE AWARENESS OF TB LINK, END PREJUDICE

The head of the United Nations agency charged with coordinating the fight against HIV/AIDS is in Brazil this week promoting awareness of the link between the epidemic and tuberculosis and the necessity to address discrimination in the South American country's response to HIV.

Brazil is home to some 40 per cent of people (730,000) living with HIV in Latin America, the largest epidemic in the region, while the next most significant HIV-positive population lives in Mexico with 200,000 people.

However, AIDS mortality rates were halved between 1996 and 2002 thanks to the country's commitment to providing access to both HIV prevention and treatment services, which has also helped stabilise the epidemic.

"We have to stop people living with HIV from dying of tuberculosis," Michel Sidibé, Executive Director of the Joint UN Programme on HIV/AIDS (UNAIDS), said at yesterday's launch of a report by the World Health Organization (WHO) on global TB control.

"Universal access to HIV prevention, treatment, care and support must include TB prevention, diagnosis and treatment. When HIV and TB services are combined, they save lives," stressed Mr. Sidibé.

Underscoring a message of solidarity with those affected by HIV and his opposition to laws blocking AIDS services, Mr. Sidibé will meet in Brasília with Government officials, the National Congress Parliamentary group on HIV, as well as civil society actors active in promoting HIV awareness, protecting human rights and ending stigma and discrimination.

One meeting will bring together national level representatives of groups representing people living with HIV, youth, women, and lesbians, gays, bisexuals and transgenders to discuss these issues within the national and local context.

Mr. Sidibé also plans to visit organizations providing vital services to children and young people in Rio de Janeiro as part of his first official trip to Brazil since becoming Executive Director of UNAIDS.
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RATE OF EPIDEMIC’S DECLINE TOO SLOW, SAYS BAN ON WORLD TB DAY

A new United Nations report notes that the percentage of the global population falling ill to tuberculosis is dropping annually, but Secretary-General Ban Ki-moon said today that the pace of the disease's decline is too slow and that efforts to combat it are "falling short."

In a message marking World TB Day, Mr. Ban said that although strides have been made, the "rate of decline is far too slow," with the disease claiming a life every 20 seconds.

"Millions of people are benefiting from treatment through coordinated national efforts, but millions more are still missing out," he said, cautioning that "unless we accelerate action, the numbers of those falling ill will continue to grow."

The report released today by the UN World Health Organization (WHO) notes that the total number of new cases in 2007 has stabilized, up to 9.27 million from 9.24 million the year before.

Rates reached their peak at 142 cases per 100,000 people in 2004, but have decreased to 137 per 100,000 people in 2007.

The Secretary-General stressed the need to intensify the fight against multi-drug resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), as well as the TB/HIV co-epidemic.

The new WHO study reveals that one-quarter of all TB deaths are HIV-related, twice as many as previous recognized. In 2007, 1.37 million people living with HIV fell ill to TB.

"These findings point to an urgent need to find, prevent and treat tuberculosis in people living with HIV and to test for HIV in all patients in order to provide prevention, treatment and care," said WHO Director-General Margaret Chan, urging countries to step up cooperation to combat both diseases.

There has been a steep climb in testing for HIV among people being treated for TB, especially in Africa, the report notes. In 2004, only 4 per cent of TB patients in the region were tested for HIV, but that has surged to 37 per cent in 2007.

"We have to stop people living with HIV from dying of tuberculosis," said Michel Sidibé, who heads the Joint United Nations Programme on HIV/AIDS (UNAIDS), underscoring the need for universal access to HIV prevention and treatment to include TB prevention, diagnosis and care.

"When HIV and TB services are combined, they save lives," the UNAIDS chief said.

In his message today, Mr. Ban welcomed the commitments made by governments, multilateral organizations, non-governmental organizations (NGOs), foundations, the private sector, academia and researchers to halt and reverse the spread of the disease and press ahead with efforts to reach the Millennium Development Goals (MDGs), eight anti-poverty targets with a 2015 deadline.

"In this time of economic crisis, we must protect investments in global health, particularly to protect the most vulnerable," he said, calling for partnership and innovation to "prevent disease, save lives and enable communities to thrive."
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