This is an archive of the Treatment Action Campaign's public documents from December 1998 until October 2008. I created this website because the TAC's website appears unmaintained and people were concerned that it
was becoming increasingly hard to find important documents.

The menu items have been slightly edited and a new stylesheet applied to the site. But none of the documents have been edited, not even for minor errors. The text appears on this site as obtained from the Internet Archive.

The period covered by the archive encompassed the campaign for HIV medicines, the civil disobedience campaigns, the Competition Commission complaints, the 2008 xenophobic violence and the PMTCT, Khayelitsha health workers and Matthias Rath court cases.

TAC Electronic Newsletter

21 June 2006

TAC/TAG Africa TB/HIV Workshop

Go to Conference Presentations and Coverage

Cape Town

19-21 June 2006

Over 70 activists from 22 African countries met in Cape Town for a workshop on HIV and tuberculosis (TB) advocacy from 19 to 21 June 2006.

HIV and TB Epidemics

Many countries in sub-Saharan Africa have large HIV epidemics. TB though treatable is a leading causes of deaths in people with HIV, more so than any other opportunistic infection.  Africa has many of the high TB burden countries in the world.  The meeting heard that in countries with TB epidemics, people with HIV have a 10% chance of developing TB each year, compared to 10% in a life time for people who do not have HIV.  Consequently most countries with large HIV epidemics also have large TB epidemics.

There are several challenges to the successful management of TB epidemics in developing countries. Key among these is that TB is difficult to diagnose, especially in people with advanced HIV-disease. Nearly two thirds of people with HIV who have TB have extra pulmonary or smear negative TB which will be missed by the most commonly used diagnostic tool. The more accurate TB diagnostics using culture technology take up to two months to deliver results, during which time many people with TB and HIV will die without being diagnosed.  The current treatment is cumbersome and requires four  drugs for two months and two for six months at a minimum. The additional challenge is that the most powerful TB drug cannot be used with many HIV medications. These challenges in TB treatment lead to lack of adherence which can lead to multi-drug resistant TB. The prices of medicines for multi-drug resistant TB, which is a growing problem and ever present threat, are more than 100 times more expensive than first line TB drugs.

New but inaccessible technologies

There are however technologies that accurately diagnose TB quickly. However they are not easily accessible due to cost.  There are new drugs, diagnostics, and vaccines in the pipeline but due to lack of political will and underfunding, these new technologies might not be realised.  The current gap for TB programs and research for the next ten years is estimated at 31 billion USD (approx. R217 billion).   


Directly observed treatment support (DOTS) is the standard mechanism for monitoring medication adherence in TB patients. However it is our view that DOTS is inadequate. In contrast to the adherence model for HIV in which patients are treated autonomously and with dignity, TB patients have their autonomy reduced by DOTS. Yet adherence rates are much better for HIV patients than TB ones. The World Health Organisation has, with activist pressure, slowly realised that DOTS is an inadequate adherence model and that the management of TB should move towards a similar model to HIV. At country level however, there has been little progress to integrate HIV and TB treatment and move away from the DOTS model.

Mortality due to HIV and TB in South Africa

In South Africa, TB is the biggest recorded cause of death. On 31 May 2006 Statistics South Africa released an updated mortality report. The new report includes all recorded deaths for 2003 and a partial record of the recorded deaths for 2004. We learn the following from the report:

We have a crisis of death in South Africa. This crisis is caused by the HIV epidemic which has resulted in deaths due to TB and other opportunistic infections spiralling. We therefore call on President Mbeki to lead us through this crisis by recognising that the HIV epidemic is an emergency.