Open Letter to the Governments of the World:
Open Letter to the Governments of the World:
As leaders gather in New York for the “Global Leaders Forum on TB/HIV,” we write as civil society groups, advocates, researchers, and groups of people living with TB and HIV from sixty five countries around the world to demand concrete action on TB and HIV.
We express our collective outrage that TB, despite being curable for over a half century, continues to be the leading cause of death of People Living With HIV/AIDS (PLWH/A). We call on governments and multilateral institutions to take bold and concrete action—and commit ourselves to the same—to ensure that every person in need receives high quality TB and HIV treatment, prevention, diagnostics and care.
Below you will find a call to action from Civil Society—as we add our voices to the leaders gathered in New York June 9th. In 2006, the UN Political Declaration on HIV/AIDS called for “accelerated scale-up of collaborative activities on tuberculosis and HIV, in line with the Global Plan to Stop TB.” Since then some nations have seen major scale-up, but the vast majority of people with TB/HIV co-infection still do not have access to coordinated services.
The world must treat TB/HIV as the crisis that it is. In Sub-Saharan Africa currently up to 50% of people living with HIV will develop TB—they are 30 times more likely to develop active TB. Multi-Drug Resistant (MDR) TB, including Extensively Drug Resistant (XDR) TB, is poised to become the next pandemic—and already has frighteningly high mortality amongst people with HIV. An effective response must be mobilized immediately.
We understand that, if universal access to existing high quality TB/HIV care and services were available by 2015, we could likely cut the current mortality rates by 80%–saving the lives of hundreds of thousands of people each year. As a matter of urgency, we call upon governments of the world to move beyond declarations and provide the plans, the resources, and the effective programs to stop these intertwined pandemics.
We demand that governments immediately and publicly announce:
UNIVERSAL ACCESS TO HIGH QUALITY TB/HIV CARE BY 2015: By 2015, in high burden areas, every person living with HIV should be screened for TB, every person with TB should be offered HIV counseling and testing, and treatment, prevention, and care must be universally available and coordinated for both diseases. This must be coordinated with a scale up to Universal Access on HIV by 2010.
FULL FUNDING: Donor and high burden country governments must announce specifically how they will fund the at least $19 billion through 2015 needed to ensure existing high quality TB/HIV care is available to all and that new tools are on the way.
REDUCE TB/HIV MORTALITY: Country plans should monitor progress to reduce mortality to no more than 90,000 by 2010 and 50,000 by 2015—an 80% reduction over our current course.
21st CENTURY DIAGNOSTICS & TREATMENT: A tangible global commitment must be announced to developing and ensuring access to 21st century diagnostic and treatment tools so that co-infected people are screened and treated more effectively.
Signed,
- ActionAid International
- ActUP Philadelphia, USA
- Africa Action, USA
- African Council of AIDS Service Organizations (AfriCASO), Africa
- Africa Public Health 15% Now Campaign, Africa
- African Services Committee, USA
- Afro Global Alliance, International
- AIDS and Rights Alliance for Southern Africa
- AIDS Law Project, South Africa
- The AIDS Institute, USA
- Aid for AIDS International
- AID FOR AIDS, Peru
- Albay Council on Reproductive Track Infection Control, Philippines
- Alliance Burundais Contre le SIDA, Burundi
- Alma Viva, Chile
- American Jewish World Service, USA
- American Medical Student Association, USA
- Amity Humanity Foundation, India
- Anonimous AIDS Association, Hungary
- Argentinean Network of Women Living with HIV/AIDS, Argentina
- Asociación LGTB Colectivo Violeta, Honduras
- Association Agua Buena, Costa Rica
- Asociacion Civil Amavida, Venezuela
- Association Laafi La Viim, Burkina Faso
- Asociacion Nacional de Personas Positivas "Vida Nueva", El Salvador
- Asociaciòn PROSA, Peru
- Associação de Reintegração dos Jovens/Crianças na Vida Social, Angola
- Asociación de ayuda al Sero Positivo, Uruguay
- Aeras Global TB Vaccine Foundation, USA
- Asian Harm Reduction Network (AHRN), Asia
- Asia Pacific Coalition on Male Sexual Health (APCOM), Asia
- Asia Pacific Council of AIDS Service Organizations (APCASO), Asia
- Asia Pacific Network of People living with HIV/AIDS (APN+), Asia
- Coordination of Action Research on AIDS and Mobility Asia (CARAM Asia), Asia
- Asia Pacific Network of People Living with HIV/AIDS (APN+), Asia
- Asia Pacific Rainbow, Asia
- Association African Solidarité, Burkina Faso
- Avocats pour La Sante dans le Monde, France
- Beijing Aizhixing Institute, China
- Botswana Couples Forum, Botswana
- Botswana Network of Ethics, Law and HIV/AIDS, Botswana
- Botswana Treatment Literacy Coalition, Botswana
- British Columbia Lung Association, Canada
- Brigham and Women’s Hospital, Division of Social Medicine and Health Inequalities, USA
- Burundian Human Rights League Iteka, Burundi
- Canadian HIV/AIDS Legal Network, Canada
- Canadian Lung Association, Canada
- Canadian Federation of Medical Students, Canada
- Centre for the AIDS Programme of Research in South Africa, South Africa
- Centre for Harm reduction, Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia
- Caribbean Vulnerable Communities Coalition, Caribbean
- Child Foundation of India
- China AAI AIDS NGO Network (CAANN), China
- Christian Aid, United Kingdom
- Ciudadanos en Apoyo a los Derechos Humanos, A.C., Mexico
- Coalicion Ecuatoriana De Personas Que Viven Con VIH/SIDA (CEPVVS), Ecuador
- Coalition of Asia Pacific Regional Networks on HIV/AIDS, Asia
- Coalition of Women Living with HIV and AIDS in Malawi
- Comité Técnico CIAT, Bolivia
- Communication for Development Centre, Nigeria
- Community Health Action Network & Volunteers for Community Mental Health, India
- Companions on a Journey, Sri Lanka
- Consortium to Respond Effectively to the AIDS/TB Epidemic (CREATE), USA
- Damien Foundation, Belgium
- Delhi Network of Positive people (DNP+), India
- Estonian Network of People Living with HIV/AIDS, Estonia
- Ethiopia Treatment Access Movement
- European AIDS Treatment Group (EATG), Belgium
- EMPOWER, India
- FISS MST/SIDA, Cameroon
- For Family and Health Pan-Armenian Association, Armenia
- The Foundation for Research in Community Health, India
- François-Xavier Bagnoud Center for Health and Human Rights, Harvard University, USA
- Friends of the Global Fight, USA
- Fundación Huellas, Ecuador
- Fundación Huésped, Argentina
- German Leprosy & TB Relief Association
- Ghana Coalition of NGOs in Health, Ghana
- Global Action for Children, USA
- Global AIDS Alliance, USA
- Global Alliance for TB Drug Development, International
- Global Health Advocates, India
- Global Harmony, India
- Global Youth Coalition on HIV/AIDS, International
- Goodwill Aid, Ghana
- Good Neighbour Inc., Nigeria
- Grupo de Ayuda Mutua "Amigos por Siempre" Callao, Peru
- Grupo CLARA, Dominican Republic
- Grupo Português de Activistas sobre Tratamentos de VIH/SIDA (GAT), Portugal
- Guyana Rainbow Association, Guyana
- HALT-SIDA, DR Congo
- Harvard Medical School, Department of Social Medicine, USA
- Health Alliance International, USA
- HealthGAP (Global Access Project), USA
- HealthNet TPO, The Netherlands
- Health, Environment & Agriculture Development Program, Nepal
- HIV/AIDS Task Force, Africa Japan Forum, Japan
- HIV Medicine Association, USA
- Hope Care Foundation, Ghana
- Human Rights Working Group on HIV/AIDS and Public Health, McGill Faculty of Law, Canada
- International Services Association, India
- Instituto de Estudios Legales del Sur, Uruguay
- Initiatives for Research and Training for Development, Cameroon
- Initiative for Community Development, Nigeria
- Interagency Coalition on AIDS and Development (ICAD), United Kingdom
- International Community of Women Living with HIV and AIDS, Southern Africa
- International Council of AIDS Service Organizations (ICASO), International
- International Peace Initiatives, Kenya
- Intersect Worldwide, US, India
- Intimate Friends International, Cameroon
- Junta Parroquial de La Merced, Ecuador
- Kara Counseling and Training Trust, Zambia
- Kenya AIDS NGOs Consortium, Kenya
- Knowledge Ecology International, USA/Switzerland
- KNCV Tuberculosis Foundation, The Netherlands
- Lanka+, Sri Lanka
- Lawyers Collective, HIV/AIDS Unit, India
- LHL – Norwegian Heart and Lung Patient Organization, Norway
- Life Goes On, Dominica
- Living Positively, Canada
- Malaysian Treatment Access & Advocacy Group (MTAAG+), Malaysia
- Malaysian AIDS Council, Malaysia
- Medical Care Development Inputs –MCDI, Kenya
- Medical Care Development, South Africa
- Media Network on HIV/AIDS and Development (MedNAD), Nigeria
- Migrant Clinicians Network, USA
- Mozambique AIDS Treatment Access Movement, Mozambique
- MSM: No Political Agenda (MSMNPA), Trinidad & Tobago
- Mumbai Thane HIV Project, World Vision India, India
- National Group of TB People, Pakistan
- Naz Foundation India Trust, India
- Network of Zimbabwean Positive Women (NZPW+), Zimbabwe
- New Jersey Medical School Global Tuberculosis Institute, USA
- Nyaya Health, Nepal
- Observatoria Latinoamerican De Prisiones Y Encierro, Latin America
- Observatoire des Droits des Personnes Infectées et/ou Affectées par le VIH/SIDA (odpia+), Burundi
- Organizacion de Mujeres Trabajadoras y ex Trabajadoras Sexuales Mexicanas, Mexico
- Niu Ailan Bilas Peles Oltaim – Yumi Bung Wantaim long Paitim sik AIDS, TB na Malaria, Papua New Guinea
- Pan African Treatment Access Movement, Africa
- Pakistan National AIDS Consortium, Pakistan
- Partners In Health, USA
- PATH, Cambodia
- PATH, Kenya
- Participatory Development Action Program (PDAP), Bangladesh
- Perspectiva Social, Argentina
- Physicians for Human Rights, USA
- Pinoy Plus Association—Association of People Living with HIV/AIDS, Philippines
- Positive Life Association of Nigeria (PLAN), Nigeria
- Positive Lives Foundation (PLF-GOA), India
- Pro-Health Initiative, Nigeria
- Project RING, Japan AIDS and Society Association, Japan
- Raks Thai Foundation, Thailand
- RAVANE+ – People Living with HIV and AIDS in the Indian Ocean – Mauritius, Madagascar, Seychelles
- Regional AIDS Training Centre and Network, India
- Public Personalities Against AIDS Trust, Zimbabwe
- Puerto Rico Community Network on Clinical Research on AIDS, Puerto Rico
- Red de Abogados Defensores de Derechos Humanos, Venezuela
- Red Nacional de Personas que Viven con el VIH de Bolivia (REDBOL), Bolivia
- Red Uruguaya de PS (REDLA+), Uruguay
- Reproductive Health Association of Cambodia (RHAC), Cambodia
- Réseau Nigérien de Personnes Vivant Avec le VIH/SIDA, Nigeria
- RESULTS Educational Fund, USA
- RESULTS Canada
- RESULTS Japan
- RESULTS UK
- Russian Harm Reduction Network, Russia
- Sequella, Inc., USA
- Slums Information Development & Resource Centres (SIDAREC), Kenya
- Sociedade Terra Viva, Brazil
- Society for Participatory Research In Asia (PRIA), India
- Social Help & Research Organization (SHRO), Pakistan
- Solthis, France
- Southern Africa HIV/AIDS Information Dissemination Service, Africa
- Southern Africa Human Rights NGO Network(SAHRiNGON), Tanzania
- South Asia Women Media Association, Pakistan
- Spiritia Foundation, Indonesia
- Stop HIV/AIDS in India Initiative (SHAII), USA
- Stop AIDS, Liberia
- STOP TB Italy
- Stop TB Partnership, Ghana
- St. Mary Cottage Hospital, Kenya
- St.Mary’s Health Care Network, Armenia
- Students Against Global AIDS (SAGA), Canada
- Student Global AIDS Campaign, USA
- Student Global AIDS Campaign, Cameroon
- Swiss Emmaus Leprosy Relief, Switzerland
- Task Force of Empowerment for Migrant Workers and Spouses, Malaysia
- Target Tuberculosis, United Kingdom
- TB Alert, United Kingdom
- TB Voice Network, Ghana
- Treatment Action Campaign, South Africa
- Treatment Advocacy and Literacy Campaign, Zambia
- Treatment Action Movement (TAM), Nigeria
- Treatment Action Group, USA
- Tuberculosis Television Organisation Studio1, Zambia
- United Civil Society Coalition on HIV/TB and MALARIA, Kenya
- United Methodist Church, General Board of Church & Society, USA
- Vermont Global Health Coalition, USA
- World AIDS Campaign, The Netherlands & South Africa
- World Vision, France
- Young Activists Against AIDS, Ghana
- Youth Coalition on Sexual and Reproductive Rights, International
- Youth Vision Services, Nepal
- Zambia Association for the Prevention of HIV and Tuberculosis (ZAPHIT), Zambia
CIVIL SOCIETY CALL TO ACTION
FOR THE “TB/HIV GLOBAL LEADERS FORUM”
We, as civil society groups, advocates, researchers, and groups of people living with TB and HIV, in anticipation of the first TB/HIV Global Leaders’ Forum meeting at the United Nations in New York on 9 June 2008,
Recalling the UN General Assembly Political Declaration on HIV/AIDS (2006) emphasizing the need for accelerated scale-up of collaborative activities on tuberculosis and HIV, and the World Health Assembly Resolution (2007) requesting countries to immediately address extensively drug-resistant TB and HIV-related TB as the highest health priorities;
Noting that HIV and TB are major constraints for socio-economic development and that investing in joint TB and HIV/AIDS interventions will contribute positively to the achievement of the Millennium Development Goals on health and poverty reduction by keeping people healthy and productive;
Dismayed that every twenty seconds a person dies of TB and that mortality rates have escalated over the past ten years, despite tuberculosis being a preventable and curable disease, and notwithstanding global commitments to halve TB mortality by 2015;
Particularly dismayed by the increasing proportion of people living with HIV who are infected by, and dying from, TB; and worried that this has not corresponded with sufficient scale-up of TB/HIV collaborative activities – in defiance of Universal Access targets;
Concerned that we, PLWHA, are placed at risk by poor infection control practices in healthcare facilities, that render health care workers and people living with HIV extremely vulnerable in the very settings where we are obliged to access and provide healthcare;
Alarmed by the devastating spread of multi-drug resistant tuberculosis and extensively drug-resistant tuberculosis, which are particularly lethal in people living with HIV;
Appalled that the standard diagnostic TB test has changed little in over a century and routinely fails to detect TB in people living with HIV and that systems for the diagnosis and early detection of tuberculosis in those living with HIV have not improved substantially in the past few years, in spite of commitments at the national and international levels to this effect;
Emphasizing the critical need for governments to empower and engage communities and wider civil society in the response to TB;
Concerned by the inadequate investment of resources – both at the national and international levels – in a comprehensive TB research agenda targeted at improving the prevention, diagnosis and treatment of TB;
Recognizing the need to examine and address our shortcomings in meeting global targets for the prevention, diagnosis and treatment of TB;
Confirming that saving lives among people living with HIV and cutting mortality associated with TB by at least 80% compared to current rates requires bold leadership and decisive, urgent action at all levels;
URGE all UN Member States, and CALL on Organizations of the United Nations system; intergovernmental and nongovernmental organizations, the corporate sector, foundations, donors, communities and the international community as a whole:
To reaffirm and evaluate their commitment to the global fight against TB/HIV and in country statements, during remarks, roundtables and discussions to:
Commit the resources necessary to ensure universal access to high quality TB/HIV care by 2015, which could reduce TB-associated deaths among people living with HIV by 80%.
Work toward cutting TB related mortality among people living with HIV to 90,000 by 2010 and 50,000 by 2015—an 80% reduction over our current course.
Commit the minimum $19 billion needed through 2015 including $14 billion necessary to universal access to high quality TB/HIV care and $5 billion for research required to yield new TB tools.
Critically evaluate the progress made in the response to TB/HIV, identify the major challenges herein, and develop and implement strategies to overcome these challenges;
Expand and accelerate the coordination between national TB and HIV programs in line with the WHO TB/HIV Collaborative Policies to achieve Universal Access to TB services for all persons at risk for or living with HIV/AIDS, as agreed upon by the 2006 General Assembly Political Resolution on AIDS;
Immediately act on the recent UNAIDS commitment to monitor TB mortality in people living with HIV by making this an integral part of TB/HIV indicators on the national level;
Prioritize education and mobilization around TB infection control and treatment in communities, health care facilities and other institutions – particularly for people living with HIV and other communities at high-risk for TB/HIV;
Expressly commit resources to research around development and promotion of better tools – including drugs, diagnostics and a vaccine – for prevention, diagnosis, and treatment of TB that are effective for those living with HIV.
Systematically include TB and TB/HIV in broader development and poverty reduction strategies, and strengthen health systems across the board to be able to effectively respond to the need; and
Actively pursue the involvement of communities and wider civil society in developing and implementing effective responses to TB/HIV.
Ensure TB and TB/HIV case detection and cure rates are indicators within health sector reviews.
REQUESTS THE UN SECRETARY GENERAL (through his Special Envoy to Stop TB):
To engage governments and civil society in resource mobilization and in ongoing monitoring, evaluation and strengthening of the global response to TB;
To report regularly on progress in addressing TB/HIV to the UN General Assembly Special Session on the HIV/AIDS Epidemic, High Level Meetings on HIV/AIDS and other important meetings convened by the United Nations System.
To report back on progress at the Stop TB Partnership Partner’s Forum, to be held in March 2009 in Rio de Janeiro, Brazil.