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As the world marks World AIDS Day on December 1, a stark reminder of the ongoing global health crisis comes from the latest Global Tuberculosis Report released by the World Health Organization (WHO) in November 2024. The report highlights a troubling statistic: tuberculosis (TB) remains the leading cause of death among people living with HIV/AIDS. In 2023, an estimated 8.2 million people were newly diagnosed with TB, the highest number recorded since the WHO began global TB monitoring in 1995. Among those living with HIV, 161,000 people died from HIV-associated TB last year alone.
The American Thoracic Society (ATS) and its partners in the Forum of International Respiratory Societies (FIRS) are calling on governments, health organizations, and non-governmental groups to enhance their responses to both AIDS and tuberculosis. Together, they aim to fulfill the WHO’s goal of ending the AIDS epidemic by 2030.
A Joint Effort to Combat TB and HIV/AIDS
Dr. Irina Petrache, President of the ATS, emphasized the urgency of addressing the crisis, particularly the rising threat of multidrug-resistant TB (MDR-TB), which is complicating global efforts to control the disease. “Multidrug-resistant TB remains a public health crisis,” Petrache stated. “In 2023, while an estimated 400,000 people developed MDR-TB or rifampicin-resistant TB, only 44% received the proper diagnosis and treatment. We must continue advocating for global funding and research for new TB vaccines and treatments.”
The ATS, which began in 1905 as the National Association for the Study and Prevention of Tuberculosis, and its FIRS members—representing top respiratory societies worldwide—are working together to improve global lung health, with a focus on both TB and HIV/AIDS. Despite significant progress in the fight against AIDS, TB remains a formidable challenge, especially in regions where the two diseases intersect.
The Persistent Threat of HIV-Associated TB
In many low- and middle-income countries, TB is often the first sign that a person has HIV. However, WHO reports that about half of those living with both HIV and TB are unaware of their co-infection, which prevents them from receiving the appropriate care needed to prevent serious illness or death. This dual epidemic continues to have a disproportionate impact in the WHO African Region, which bears the highest burden of HIV-associated TB. People living with HIV are 16 times more likely to develop TB than those without the virus.
In addition to TB, HIV increases the risk of other severe respiratory infections, including Pneumocystis jirovecii pneumonia and bacterial pneumonia, both of which can be fatal if not properly treated.
Progress and the Need for Continued Action
While the number of AIDS-related deaths has decreased by 69% since its peak in 2004, thanks to education, prevention strategies, and the widespread use of antiretroviral therapy (ART), the fight is far from over. The need for greater awareness, better patient care, and more research into prevention and treatment strategies for both HIV and TB is critical to further reducing the burden of these diseases.
FIRS advocates for a multi-faceted global response to these interconnected epidemics, focusing on the following key actions:
- Increasing Awareness: Ensuring that the global community recognizes the ongoing threat of HIV-related diseases and their link to TB and other respiratory infections.
- Improving Health Outcomes: Advancing patient care and research to improve the prevention, early diagnosis, and treatment of both HIV and TB, including the rapid diagnosis and treatment of multidrug-resistant TB.
- Strengthening Prevention Programs: Enhancing efforts to prevent mother-to-child transmission of HIV and promoting the early use of antiretroviral therapy.
- Expanding HIV Education: Increasing HIV education and prevention efforts in at-risk communities to curb new infections.
- Reducing Health Inequities: Tackling the health disparities and inequities that disproportionately affect vulnerable populations.
As World AIDS Day approaches, the message is clear: while significant strides have been made in the fight against HIV/AIDS, tuberculosis continues to claim lives, particularly among those already living with HIV. A renewed global effort is needed to ensure that the end of the AIDS epidemic also brings an end to its deadliest co-infection—tuberculosis.
