TB/HIV: Impact and Opportunities

Helene Gayle, MD, MPHBill and Melinda Gates FoundationDATE, 2004

Small and Fujiwara, N Eng J Med 343:189, 2001

The annual risk of TB in HIV infected

approximates the lifetime risk of HIV uninfected

HIV/TB: Profound Effect on Individuals

HIV/TB: Profound Effect on Populations

Kenyon et al., Int J TB Lung Dis 1999;3:4-11

HIV/TB: Profound Effect on Populations

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88 89 90 91 92 93 94 95 96 97 98 99 '00 '01Year

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r 100

,000

South Africa Kenya Swaziland Malawi

Zambia Namibia Botswana

WHO TB Surveillance Report, 2003

TB/HIV Co-Authorship Network

Medline 97-01Medline 97-01 TB 12,352TB 12,352 HIV 43,455HIV 43,455““Top” 50 authorsTop” 50 authors

Separate Responses

Abernethy and Small, unpublished

A Coordinated Response

C R E A ETo design, implement and evaluate a portfolio of community level trials of new strategies to reduce tuberculosis incidence in populations with high rates of HIV and TB co-infection.

TB/HIV Ultimate Need for New Tools

FIND/TDR for diagnostics ($30M)

Global Alliance for new drug ($25 M)

Aeras for vaccines ($83M)

Reaping the benefitsReaping the benefitsof science of science