Open letter and call to action on TB/HIV to governments of the world signed by 204 civil society organizations


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.





  1. ActionAid International
  2. ActUP Philadelphia, USA
  3. Africa Action, USA
  4. African Council of AIDS Service Organizations (AfriCASO), Africa
  5. Africa Public Health 15% Now Campaign, Africa
  6. African Services Committee, USA
  7. Afro Global Alliance, International
  8. AIDS and Rights Alliance for Southern Africa
  9. AIDS Law Project, South Africa
  10. The AIDS Institute, USA
  11. Aid for AIDS International
  12. AID FOR AIDS, Peru 
  13. Albay Council on Reproductive Track Infection Control, Philippines
  14. Alliance Burundais Contre le SIDA, Burundi
  15. Alma Viva, Chile
  16. American Jewish World Service, USA
  17. American Medical Student Association, USA
  18. Amity Humanity Foundation, India
  19. Anonimous AIDS Association, Hungary
  20. Argentinean Network of Women Living with HIV/AIDS, Argentina
  21. Asociación LGTB  Colectivo Violeta, Honduras
  22. Association Agua Buena, Costa Rica
  23. Asociacion Civil Amavida, Venezuela
  24. Association Laafi La Viim, Burkina Faso
  25. Asociacion Nacional de Personas Positivas "Vida Nueva", El Salvador 
  26. Asociaciòn PROSA, Peru
  27. Associação de Reintegração dos Jovens/Crianças na Vida Social, Angola
  28. Asociación de ayuda al Sero Positivo, Uruguay
  29. Aeras Global TB Vaccine Foundation, USA
  30. Asian Harm Reduction Network (AHRN), Asia
  31. Asia Pacific Coalition on Male Sexual Health (APCOM), Asia
  32. Asia Pacific Council of AIDS Service Organizations (APCASO), Asia
  33. Asia Pacific Network of People living with HIV/AIDS (APN+), Asia
  34. Coordination of Action Research on AIDS and Mobility Asia (CARAM Asia), Asia
  35. Asia Pacific Network of People Living with HIV/AIDS (APN+), Asia
  36. Asia Pacific Rainbow, Asia
  37. Association African Solidarité, Burkina Faso
  38. Avocats pour La Sante dans le Monde, France
  39. Beijing Aizhixing Institute, China
  40. Botswana Couples Forum, Botswana 
  41. Botswana Network of Ethics, Law and HIV/AIDS, Botswana 
  42. Botswana Treatment Literacy Coalition, Botswana 
  43. British Columbia Lung Association, Canada
  44. Brigham and Women’s Hospital, Division of Social Medicine and Health Inequalities, USA
  45. Burundian Human Rights League Iteka, Burundi
  46. Canadian HIV/AIDS Legal Network, Canada 
  47. Canadian Lung Association, Canada
  48. Canadian Federation of Medical Students, Canada
  49. Centre for the AIDS Programme of Research in South Africa, South Africa 
  50. Centre for Harm reduction, Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia
  51. Caribbean Vulnerable Communities Coalition, Caribbean
  52. Child Foundation of India
  53. China AAI AIDS NGO Network (CAANN), China
  54. Christian Aid, United Kingdom
  55. Ciudadanos en Apoyo a los Derechos Humanos, A.C., Mexico
  56. Coalicion Ecuatoriana De Personas Que Viven Con VIH/SIDA (CEPVVS), Ecuador
  57. Coalition of Asia Pacific Regional Networks on HIV/AIDS, Asia
  58. Coalition of Women Living with HIV and AIDS in Malawi 
  59. Comité Técnico CIAT, Bolivia
  60. Communication for Development Centre, Nigeria
  61. Community Health Action Network & Volunteers for Community Mental Health, India
  62. Companions on a Journey, Sri Lanka
  63. Consortium to Respond Effectively to the AIDS/TB Epidemic (CREATE), USA
  64. Damien Foundation, Belgium
  65. Delhi Network of Positive people (DNP+), India
  66. Estonian Network of People Living with HIV/AIDS, Estonia
  67. Ethiopia Treatment Access Movement
  68. European AIDS Treatment Group (EATG), Belgium
  69. EMPOWER, India
  70. FISS MST/SIDA, Cameroon
  71. For Family and Health Pan-Armenian Association, Armenia
  72. The Foundation for Research in Community Health, India
  73. François-Xavier Bagnoud Center for Health and Human Rights, Harvard University, USA
  74. Friends of the Global Fight, USA
  75. Fundación Huellas, Ecuador
  76. Fundación Huésped, Argentina
  77. German Leprosy & TB Relief Association
  78. Ghana Coalition of NGOs in Health, Ghana 
  79. Global Action for Children, USA
  80. Global AIDS Alliance, USA
  81. Global Alliance for TB Drug Development, International
  82. Global Health Advocates, India
  83. Global Harmony, India
  84. Global Youth Coalition on HIV/AIDS, International
  85. Goodwill Aid, Ghana
  86. Good Neighbour Inc., Nigeria
  87. Grupo de Ayuda Mutua "Amigos por Siempre" Callao, Peru
  88. Grupo CLARA, Dominican Republic
  89. Grupo Português de Activistas sobre Tratamentos de VIH/SIDA (GAT), Portugal
  90. Guyana Rainbow Association, Guyana
  91. HALT-SIDA, DR Congo
  92. Harvard Medical School, Department of Social Medicine, USA
  93. Health Alliance International, USA
  94. HealthGAP (Global Access Project), USA
  95. HealthNet TPO, The Netherlands
  96. Health, Environment & Agriculture Development Program, Nepal
  97. HIV/AIDS Task Force, Africa Japan Forum, Japan
  98. HIV Medicine Association, USA
  99. Hope Care Foundation, Ghana
  100. Human Rights Working Group on HIV/AIDS and Public Health, McGill Faculty of Law, Canada
  101. International Services Association, India
  102. Instituto de Estudios Legales del Sur, Uruguay
  103. Initiatives for Research  and Training for Development, Cameroon
  104. Initiative for Community Development, Nigeria
  105. Interagency Coalition on AIDS and Development (ICAD), United Kingdom
  106. International Community of Women Living with HIV and AIDS, Southern Africa 
  107. International Council of AIDS Service Organizations (ICASO), International
  108. International Peace Initiatives, Kenya
  109. Intersect Worldwide, US, India
  110. Intimate Friends International, Cameroon
  111. Junta Parroquial de La Merced, Ecuador
  112. Kara Counseling and Training Trust, Zambia 
  113. Kenya AIDS NGOs Consortium, Kenya
  114. Knowledge Ecology International, USA/Switzerland
  115. KNCV Tuberculosis Foundation, The Netherlands
  116. Lanka+, Sri Lanka
  117. Lawyers Collective, HIV/AIDS Unit, India
  118. LHL – Norwegian Heart and Lung Patient Organization, Norway
  119. Life Goes On, Dominica
  120. Living Positively, Canada 
  121. Malaysian Treatment Access & Advocacy Group (MTAAG+), Malaysia
  122. Malaysian AIDS Council, Malaysia
  123. Medical Care Development Inputs –MCDI, Kenya
  124. Medical Care Development, South Africa
  125. Media Network on HIV/AIDS and Development (MedNAD), Nigeria
  126. Migrant Clinicians Network, USA
  127. Mozambique AIDS Treatment Access Movement, Mozambique
  128. MSM: No Political Agenda (MSMNPA), Trinidad & Tobago
  129. Mumbai Thane HIV Project, World Vision India, India
  130. National Group of TB People, Pakistan
  131. Naz Foundation India Trust, India
  132. Network of Zimbabwean Positive Women (NZPW+), Zimbabwe
  133. New Jersey Medical School Global Tuberculosis Institute, USA
  134. Nyaya Health, Nepal
  135. Observatoria Latinoamerican De Prisiones Y Encierro, Latin America
  136. Observatoire des Droits des Personnes Infectées et/ou Affectées par le VIH/SIDA (odpia+), Burundi
  137. Organizacion de Mujeres Trabajadoras y ex Trabajadoras Sexuales Mexicanas, Mexico
  138. Niu Ailan Bilas Peles Oltaim – Yumi Bung Wantaim long Paitim sik AIDS, TB na Malaria, Papua New Guinea
  139. Pan African Treatment Access Movement, Africa 
  140. Pakistan National AIDS Consortium, Pakistan
  141. Partners In Health, USA 
  142. PATH, Cambodia
  143. PATH, Kenya
  144. Participatory Development Action Program (PDAP), Bangladesh
  145. Perspectiva Social, Argentina
  146. Physicians for Human Rights, USA
  147. Pinoy Plus Association—Association of People Living with HIV/AIDS, Philippines
  148. Positive Life Association of Nigeria (PLAN), Nigeria
  149. Positive Lives Foundation (PLF-GOA), India
  150. Pro-Health Initiative, Nigeria
  151. Project RING, Japan AIDS and Society Association, Japan
  152. Raks Thai Foundation, Thailand
  153. RAVANE+ – People Living with HIV and AIDS in the Indian Ocean – Mauritius, Madagascar, Seychelles
  154. Regional AIDS Training Centre and Network, India
  155. Public Personalities Against AIDS Trust, Zimbabwe
  156. Puerto Rico Community Network on Clinical Research on AIDS, Puerto Rico
  157. Red de Abogados Defensores de Derechos Humanos, Venezuela
  158. Red Nacional de Personas que Viven con el VIH de Bolivia (REDBOL), Bolivia
  159. Red Uruguaya de PS (REDLA+), Uruguay
  160. Reproductive Health Association of Cambodia (RHAC), Cambodia
  161. Réseau Nigérien de Personnes Vivant Avec le VIH/SIDA, Nigeria 
  162. RESULTS Educational Fund, USA
  163. RESULTS Canada
  164. RESULTS Japan
  166. Russian Harm Reduction Network, Russia
  167. Sequella, Inc., USA
  168. Slums Information Development & Resource Centres (SIDAREC), Kenya
  169. Sociedade Terra Viva, Brazil
  170. Society for Participatory Research In Asia (PRIA), India
  171. Social Help & Research Organization (SHRO), Pakistan
  172. Solthis, France
  173. Southern Africa HIV/AIDS Information Dissemination Service, Africa
  174. Southern Africa Human Rights NGO Network(SAHRiNGON), Tanzania
  175. South Asia Women Media Association, Pakistan
  176. Spiritia Foundation, Indonesia
  177. Stop HIV/AIDS in India Initiative (SHAII), USA
  178. Stop AIDS, Liberia
  179. STOP TB Italy
  180. Stop TB Partnership, Ghana
  181. St. Mary Cottage Hospital, Kenya
  182. St.Mary’s Health Care Network, Armenia 
  183. Students Against Global AIDS (SAGA), Canada
  184. Student Global AIDS Campaign, USA
  185. Student Global AIDS Campaign, Cameroon
  186. Swiss Emmaus Leprosy Relief, Switzerland
  187. Task Force of Empowerment for Migrant Workers and Spouses, Malaysia
  188. Target Tuberculosis, United Kingdom 
  189. TB Alert, United Kingdom
  190. TB Voice Network, Ghana
  191. Treatment Action Campaign, South Africa 
  192. Treatment Advocacy and Literacy Campaign, Zambia
  193. Treatment Action Movement (TAM), Nigeria 
  194. Treatment Action Group, USA
  195. Tuberculosis Television Organisation Studio1, Zambia 
  196. United Civil Society Coalition on HIV/TB and MALARIA, Kenya
  197. United Methodist Church, General Board of Church & Society, USA
  198. Vermont Global Health Coalition, USA
  199. World AIDS Campaign, The Netherlands & South Africa
  200. World Vision, France
  201. Young Activists Against AIDS, Ghana
  202. Youth Coalition on Sexual and Reproductive Rights, International 
  203. Youth Vision Services, Nepal
  204. Zambia Association for the Prevention of HIV and Tuberculosis (ZAPHIT), Zambia 





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.