HIV and tuberculosis co-infection must be a policy priority in Bangladesh
29 September 2008
A study by HASAB, the Alliance’s linking organisation in Bangladesh has highlighted the country’s lack of an effective, coordinated policy action plan to address HIV and tuberculosis co-infection. The study also discovered a lack of public information about the risk of co-infection and inadequate skills among health care services providers to address the issue.
Bangladesh is heavily burdened with tuberculosis, with over 600,000 people living with the disease (the fourth highest figure worldwide). Although HIV prevalence in the country is low compared to tuberculosis and malaria, high levels of HIV-related stigma and low programme coverage, combined with widespread TB infection, poverty, malnutrition and lack of awareness emphasise the need for strategic planning to minimize the risk of HIV and tuberculosis co-infection.
Findings included:
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Stand alone TB and HIV policies
Interviews with key stakeholders revealed inadequate policy attention to HIV and TB – due in part from a lack of understanding of the issues. This lack of an effective and coordinated action plan extends from the policy level to funding to implementation.
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Inadequate skills mix among service providers
There is an enormous need for training for health care service providers (both HIV and TB) by both government and private sectors.
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A lack of information and sensititivity in implementation
At many levels in both the government and development sectors, there are no mechanisms to disseminate information to the public and affected communities about the elevated risk of HIV and TB co-infection.
The study recommends closer links between the national tuberculosis and HIV programmes to address some of the issues. Further recommendations include a comprehensive human resource/capacity development plan to deal with HIV-TB co-infection at different levels; revision of the information systems to gather information about TB-HIV services; and a joint monitoring and evaluation system to assess effectiveness – both from a quality point of view and from the perspective of patients.
HASAB carried out the ‘TB-HIV Monitoring and Advocacy’ study as a pilot intervention, aiming to gather in-depth insights in areas ranging from policy to practice. The Open Society Institute provided financial support for the study.
