1. TB/HIV Why do we care about the intersection of the epidemics? Kayt Erdahl, Technical Officer HIV/AIDS & TB Global Programs, PATH CORE Group Fall Meeting October 13, 2011

5. Global burden of TB

7. Global Burden of TB and TB/HIV, 2010 *Including deaths among people living with HIV Data from WHO Global TB Report, 2011 Estimated number of cases Estimated number of deaths All forms of TB 8.8 million 1.4 million* All forms of TB, women only 3.2 million 320,000 HIV-Associated TB 1.1 million 350,000 Multidrug-resistant TB (MDR-TB) 650,000 ~150,000 (2008)

9. Estimated HIV prevalence in new TB cases, 2010 WHO, Global TB Report 2011 1.1 million TB/HIV cases and 350,000 deaths

10. Countries with the highest number of deaths from HIV-associated TB Time to act - Save a million lives by 2015 Prevent and treat tuberculosis among people living with HIV. WHO 2011

12. Estimated TB incidence vs. HIV prevalence in high burden countries 0 400 800 1200 1600 0.0 0.1 0.2 0.3 0.4 HIV prevalence, adults 15-49 years Estimated annual TB incidence (per 100K adults , 1999) As HIV prevalence increases by 1%, TB incidence increases by 26/100k/yr Williams B. 3rd Global TB/HIV Working Group Meeting; Montreux, 4-6 June 2003

14. Global Plan to Stop TB 2011-2015 Summary of main TB/HIV indicators Data from WHO Global TB Report, 2011 TB/HIV indicators Baseline (2009) 2010 % TB patients tested for HIV 26% 34% % HIV+ TB patients treated with CPT 75% 77% % of HIV+ TB patients treated with ART 37% 46% % of PLHA attending HIV care services who were screened for TB at their last visit ~25% 58% % of PLHA attending HIV care services who were enrolled on IPT; among those eligible <1% 12%

17. Reducing TB burden among PLWHA Isoniazid preventive therapy Infection control Intensified case finding Adapted from WHO; 2009 The 3 Is Antiretroviral therapy The 4 th I

22. TB/HIV interventions scale-up by HIV/AIDS programmes In 2008 1.4 M PLHIV screened for TB (4% of PLHIV) 56,000 PLHIV enrolled on IPT (0.2% of PLHIV)