TB testing and treatment disruptions may increase HIV-related deaths

As the world marks World TB Day today, Kenya faces major challenges in TB testing and sample transportation due to a recent stop-work directive from U.S. President Donald Trump.

The move has raised concerns about a potential rise in AIDS-related deaths among people living with HIV.

In Kenya, TB remains the leading cause of illness and death among people living with HIV. However, disruptions to services and the integration of HIV care into general healthcare are resulting in missed TB diagnoses.

Nelson Otwoma, the Executive Director of the National Empowerment Network of People Living with HIV/AIDS in Kenya (Nephak), has raised concerns about the significant impact on TB testing.

“With these disruptions, we anticipate a sharp increase in cases of Advanced HIV Disease (AHD),” Otwoma told the Standard in an interview.

The US government, through USAID and PEPFAR, has played a crucial role in supporting TB care for individuals living with HIV.

Their initiatives have focused on identifying cases both in healthcare facilities and within communities, as well as enhancing diagnostic and laboratory systems to ensure timely testing.

The halt in operations has led to the abandonment of crucial TB-related services, endangering thousands of lives.

“USAID’s disruption of diagnostic and laboratory networks, coupled with the breakdown of sample transportation, means TB is no longer being detected,” Otwoma stated.

He emphasized that individuals living with HIV should undergo TB screening during every visit to a health facility.

Previously, before donor funding was withdrawn, the Comprehensive Care Unit (CCC) handled TB screening, sample collection, diagnosis, and referrals for treatment.

Meanwhile, the World Health Organization paints favorable picture about TB-related deaths in Africa, saying deaths in the continent have declined more than in any other region since 2015.

However, despite this progress, key targets to reduce the disease burden remain out of reach.

According to WHO’s Global TB Report 2024, TB-related deaths in Africa fell by 42 percent between 2015 and 2023, while cases decreased by 24 percent.

Over the same period, treatment coverage increased from 55 percent to 74 percent.

South Africa has surpassed its 2025 milestone ahead of schedule, achieving a 50 percent reduction in TB incidence.

Other countries, including Mozambique, Tanzania, Togo, and Zambia, have reached the goal of a 75 percent reduction in TB deaths.

Kenya, Malawi, Rwanda, Sierra Leone, and Uganda are also making notable progress, with mortality rates dropping by at least 66 percent.

Eastern and Southern Africa have led in reducing TB cases, cutting incidence from 466 per 100,000 people in 2000 to 266 per 100,000 in 2023.

However, progress has been slower in Central and West Africa, where TB remains a serious public health concern.

The WHO’s End TB Strategy aims for a 75 percent reduction in TB deaths and a 50 percent decline in cases by 2025, using 2015 as the baseline.

This year’s World TB Day theme, “Yes! We Can End TB: Commit, Invest, Deliver,” calls for stronger commitments and financial backing for TB control programs.