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AIDS and TB team up to kill even more, group says

More people are getting tuberculosis because of AIDS and more die of AIDS because of TB, yet doctors fail to recognize the respiratory disease in AIDS patients and governments do little about it, according to a report released on Tuesday.

Sexier topics like avian flu get immediate attention while 2 million people die every year of tuberculosis, and 9 million become infected, according to the report from the Open Society Institute, a foundation set up by financier George Soros.

Together, TB and AIDS are causing a "double plague," Stephen Lewis, the United Nations Special Envoy for AIDS in Africa told reporters in a telephone briefing.

"Governments and the international community have got to realize they have on their hands two simultaneous and interrelated catastrophes," Lewis said.

We must confront both together. We need more resources. We need diagnostics. We need better drugs."

Lewis and staffers who wrote the report said they hope to use the 16th International AIDS Conference in Toronto, which opens on Sunday, to build interest in the issue.

When people become infected with TB and AIDS it is almost "always an irreversible formula, cause for death," Lewis said.

"TB is in fact the most common cause of death for people living with AIDS," he added. "Ninety-nine percent of those infections and deaths are in the developing world."

TB can be cured with several months of treatment with antibiotics.

LIVING EXAMPLE

Ezio Santos Filho, a lawyer and AIDS and TB activist in Brazil, said he is a living example of the problem.

He has been infected with the AIDS virus since 1985 and became infected with tuberculosis in 1992 when working with Brazilian TB patients.

"When people have AIDS it is difficult to diagnose TB," Filho said.

"Normally they don't have all the symptoms, all the typical characteristics that people without AIDS would have. People cough less and people have less sputum when they have AIDS."

In addition, the report said, only a third of all TB smear tests in HIV-positive patients give an accurate positive result.

"You could do it with a chest x-ray but obviously that kind of technology is not readily available to the developing world," Lewis said.

Filho said even though Brazil has good public health care and he has private health insurance, it took him 40 days to be diagnosed.

"So this is a typical problem why TB kills so many people with HIV. Because they don't get diagnosed in time," he said.

"Also, I know all the physicians who deal with TB in the country, all the key people and still the diagnosis took so long to be done," Filho said.

The report said in Tanzania, for example, only 47 percent of TB cases are detected. Undiagnosed patients spread TB.

"And for people living with HIV/AIDS, even a short delay in accessing TB treatment can be fatal," the report said. HIV destroys the immune system. Drug cocktails can help control this but there is no cure and the drugs are usually not available in poorer countries.

Olayide Akanni of Journalists Against AIDS in Nigeria, who worked on the report, said activists, public health authorities and other experts have all failed to address the issue.

"There is no coordination between TB and HIV programs," she said. "In most programs, TB programs go underfunded and neglected."

And there is little interest, said Afsan Chowdhury of the Bangladesh Rural Advancement Committee.

"There is no interest because it is a disease of the poor," Chowdhury said. "On the other hand bird flu is quite a dramatic disease."