Global Tuberculosis Report -- 2012.pdf

FIGURE 7.7Number of people screened (millions)43210FIGURE 7.8Number of HIV-positive people without active TB(thousands)5004003002001000FIGURE 7.9Number of lives saved (millions)0.50.40.30.20.1Intensified TB case-finding among peopleliving with HIV, 2005–20112005 2006 2007 2008 2009 2010 2011Provision of isoniazid preventive therapy(IPT) to people living with HIV withoutactive TB, 2005–20112005 2006 2007 2008 2009 2010 2011Estimated number of lives saved globally bythe implementation of TB/HIV interventions,2005–2011. The blue band represents theuncertainty interval.2005 2006 2007 2008 2009 2010 2011compared with 2.3 million in 71 countries in 2010 (Figure7.7). Unfortunately, at the time this report went to press,the total number of people enrolled in HIV care in 2011was not available (the figure was 4.0 million in 2010).Nonetheless, it is clear that further progress is needed toapproach the target in the Global Plan, which is to screenall those enrolled in HIV care for TB by 2015.Among 29 countries that reported data, IPT was providedto almost 450 000 people living with HIV in 2011,more than double the 201 000 people provided with IPT in2010 (Figure 7.8). Most of the increase occurred in SouthAfrica, where 373 000 people were reported to have beenprovided with IPT in 2011, followed by Ethiopia (31 000),Mozambique (17 000) and Namibia (14 000). Unfortunately,at the time this report went to press, the totalnumber of people newly enrolled in HIV care in 2011 andpotentially eligible for IPT was not available (the figurewas 1.5 million in 2010). However, as with TB screeningamong people in HIV care, it is clear that further effortsare needed to reach the Global Plan’s 2015 target of providingIPT to all those eligible for it – estimated at approximately50% of those newly enrolled in HIV care.7.4 Lives saved by the implementationof collaborative TB/HIV activities,2005–2011In the years between the publication of WHO’s first policyon collaborative TB/HIV activities in 2004 and updatedguidance launched in 2012, 1,2 considerable progress inimplementing the recommended package of interventionsoccurred, as documented in Section 7.1, Section 7.2and Section 7.3. At the time that updated guidance waspublished in March 2012, the lives saved as a result ofthe implementation of collaborative TB/HIV activitiesbetween 2005 and 2010 were estimated. Here, the analysisis extended to 2011 and methods are explained.Four interventions were considered:● ART provided during TB treatment for people livingwith HIV;● CPT provided during TB treatment for people livingwith HIV;● IPT for HIV-positive people enrolled in HIV care;● Early TB diagnosis through systematic screening forTB among people living with HIV.These interventions were compared with a counterfactualscenario defined as no ART, no CPT, no IPT and no TBscreening.1Policy on collaborative TB/HIV activities. Geneva, World HealthOrganization, 2004 (WHO/HTM/TB/2004.330; WHO/HTM/HIV/2004.1).2WHO policy on collaborative TB/HIV activities: guidelines for nationalprogrammes and other stakeholders. Geneva, 2012 (WHO/HTM/TB/2012.1).80 GLOBAL TUBERCULOSIS REPORT 2012