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TAG-ICW TB/HIV Advocacy Project

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Battling the Dual Epidemic through Community Action

AUGUST 2008

TB/HIV: What Every HIV/AIDS Activist Should Know

by Nelson Juma Otwoma

I have always wanted to make a difference. My activism took root in my home province, Nyanza. My activism has always been focused on alleviating the burden of poverty and promoting health. I have always had an intense inner feeling that something needed to change; in fact, I was probably born an activist!

In 2001, I helped to found the Multiface Development and Research Centre (MDRC) with the mission of building local capacity to identify problems and seek suitable solutions in the areas of health and development. In the early days of activism at MDRC, my role was to say the things that no one else was saying…poor people were suffering with disease, poverty, and ignorance. MDRC was well aware of the burden caused by HIV and TB and when the opportunity presented itself, MDRC sought funding to address the burden of TB in the Suba district of Western Kenya. The intention of MDRC was to get people talking about TB and poverty in the hope that TB service delivery would improve in Suba. As the lead researcher of MDRC’s TB/HIV Advocacy project, I was able to prioritize TB/HIV as an area of interest for the organization, and this continues to be a cornerstone of my own advocacy agenda.

Through my work with TAG, ICW and other organizations supporting TB/HIV work, I have had the opportunity to learn more about advocacy. I gained knowledge about research, the skills and steps of advocacy and the lessons learned from the work done by other activists. This has helped me redefine my own TB/HIV advocacy agenda. The WHO interim policy on collaborative TB/HIV activities recommends mechanisms to coordinate planning and resource mobilization between TB and HIV programs and strategies to reduce the burden of TB among persons with HIV, and the burden of HIV amongst people with TB. This policy has provided me with a framework for my TB/HIV activism. Understanding the science and policy aspects of TB/HIV has been vital in my advocacy to make civil society a stronger partner in allocating resources, as well as making sure that government programs meet our needs. Marrying the understanding of policy, science, and research with my understanding of my community has made the advocacy of MDRC more focused and powerful.

The unique challenges presented by TB/HIV coinfection should be a focus for HIV activists worldwide. Even though TB is curable,

  • TB kills nearly 1.5 million people a year, of which 250,000 are people with HIV
  • TB is a disease of poverty with 98% of TB deaths occurring in developing countries
  • Africa has 80% of the world’s TB/HIV burden despite being only 13% of the world’s population
  • TB is the leading cause of death among people with HIV (15% of deaths due to TB globally and up to 50% in some parts of sub-Saharan Africa)


For all the above reasons, as an activist, and especially as a HIV activist I engage in TB/HIV advocacy so that we don’t continue dying of a curable disease while on HIV treatment. This advocacy is vital to raise the profile of TB among persons with HIV and stimulate response and resource allocation to TB and TB/HIV interventions Resources for how you can become engaged in TB/HIV advocacy can be found on the back page of this newsletter.