Mandela warns of TB ‘death sentence’ in AIDS war

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The global war on AIDS could be lost if the world ignores tuberculosis, often a death sentence for people infected with HIV, former South African president Nelson Mandela said on Thursday.

“The world has made defeating AIDS its top priority. This is a blessing, but TB remains ignored,” the frail Nobel laureate said at a global conference in Bangkok.

Mandela, one of the world’s leading AIDS campaigners, will address 17,000 delegates on Friday at a candle-lit closing ceremony to end a week of bickering over Washington’s drug and funding policies.

A fierce critic of the Bush administration over Iraq, Mandela steered clear of the controversy to focus on the plight of millions suffering from HIV and TB.

About 14 million people are infected with HIV and TB—70 percent living in sub-Saharan Africa, the region hardest hit by HIV/AIDS, which has killed 20 million people worldwide.

HIV destroys the immune system and makes patients more vulnerable to diseases such as tuberculosis, an infectious illness that accounts for up to one-third of all HIV/AIDS deaths.

“We cannot win the battle against AIDS if we do not also fight TB. TB is too often a death sentence for people with AIDS. It does not have to be this way,” Mandela said.

He described his own bout with the disease while imprisoned for 27 years for fighting apartheid before leading South Africa to democracy in 1994.

“I went to my friends in prison, Walter Sisulu and others, and told them I was found to have the TB germ. There were long faces drawn,” said Mandela, who recovered after four months of treatment.

Mandela, who turns 86 on Sunday, said resources for detecting and treating tuberculosis were woefully short despite the world having had a cure for more than 50 years.

ATLANTIC RIFT

Funding for the global war on AIDS has dominated debate at the conference where Bush’s AIDS czar came under fire for rejecting calls to inject $1 billion into a U.N.-backed global fund to fight AIDS, tuberculosis and malaria.

The summit has also been riven by a row over whether abstinence from sex or condoms is more effective in preventing the disease. Washington is emphasizing abstinence.

“We do have a different approach on access to condoms,” said British junior development minister Gareth Thomas.

“You have to recognize the reality that people are able to make their own decisions about their sex lives,” he said. “We need to understand that reality and increase access to condoms.”

Research into the dual tuberculosis and AIDS epidemic got a boost on Thursday with a $45 million grant from the Bill & Melinda Gates Foundation.

The philanthropic organization set up by Microsoft chairman Bill Gates said the money would fund studies into strategies to control tuberculosis in areas with high HIV infection rates.

“This is a catastrophic collision of two devastating epidemics,” said Richard Chiasson, a scientist at the Johns Hopkins Center for Tuberculosis Research leading the research consortium.

CREATE, the Consortium to Respond Effectively to the AIDS-TB Epidemic, will conduct three large-scale community studies in Africa and South America over seven years.

The researchers want to improve detection of tuberculosis to ensure people can be treated and do not infect others. They will study a therapy that aims to prevent those infected with latent tuberculosis from developing an active form of the disease.

Most developing nations use a therapy plan called DOTS, which has limited reach because it targets only those with active TB.

Health experts hope Mandela’s message will convince people with HIV and tuberculosis to tell their stories and raise awareness about the dual epidemic.

Winstone Zulu, a Zambian who spoke alongside Mandela, said he had lost four brothers because they lacked access to TB drugs, which he said should get as much attention as life-prolonging antiretroviral drugs (ARVs) for people with HIV.

“Many of these people will get TB and if they can’t get TB drugs, by the time they get ARVs they will die,” Zulu said. “If my brothers had access to TB drugs, they would be alive today.”

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