Evelyne Kibuchi is a senior tuberculosis (TB) advocacy officer at the Kenya AIDS NGOs Consortium (KANCO), a national umbrella organization of civil society groups in Kenya that collaborate for resource mobilization for TB and HIV.
Kibuchi set the stage for her presentation at the Union World Conference on Lung Health in France on Saturday by noting that Kenya ranks 13 of the 22 high burden TB countries in the world. Forty-one percent of TB patients also have HIV infection and TB is the greatest source of morbidity and mortality for persons with HIV. Rates of screening for TB among persons living with HIV are low and it is estimated that 25 to 30 percent of persons living with HIV in Kenya have undiagnosed tuberculosis.
HIV stakeholders have been slow to embrace and adopt TB interventions, Kibuchi said, and resources for co-infection activities are modest. Other challenges include the low profile of TB in Kenya despite its high disease burden and the slow flow of funding, especially from the Global Fund to Fight AIDS, Tuberculosis and Malaria.
KANCO supports TB/HIV integration by working to educate and sensitize both HIV and TB stakeholders to the issues related to TB/HIV co-infection. They have organized joint planning meetings for TB and HIV civil society organizations and have tried to build the capacity of each group to deal with issues relevant to both diseases. They have been successful in advocating for the inclusion of TB indicators in the HIV national plan, and for their inclusion of TB indicators within the national reporting tools. . There is now a TB/HIV integration desk within the national AIDS office. They have developed relevant advocacy messages and taken these to members of parliament both in Kenya and in donor countries. They are mentoring current and former HIV-affected TB patients to engage in TB/HIV and TB control activities, including treatment support, community education, intensified case finding and treatment defaulter tracing. The Kenya Ethical and Legal Network has taken up advocacy for TB patients in addition to their HIV human rights focus. KANCO was also successful in integrating TB services within a drop-in center providing HIV care and services to commercial sex workers.
There are still obstacles to progress in this area, according to Kibuchi. HIV and TB means double stigma and there has been minimal advocacy engagement from networks of people living with HIV. Kenya lacks quality and up-to-date data on TB/HIV co-infection.
The national HIV strategic plan is currently under review and KANCO plans to use this opportunity to review and assess the TB indicators while continuing to advocate for integration and the resources to make it possible at the national level.