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Mandela Urges More Action Against ‘Ignored’ Tuberculosis

Times Staff Writer

Nelson Mandela made an impassioned plea to the 15th International AIDS Conference on Thursday for more funds to fight tuberculosis, the lung disease that is the leading cause of death among AIDS victims in Africa.

“The world has made defeating AIDS a top priority. This is a blessing, but TB remains ignored,” said the former South African president, who will turn 86 on Sunday.

Mandela appeared frail, and friends said his appearance Thursday and his speech during the closing ceremony today could be among his last public appearances.

“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.

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The tubercle bacillus attacks people whose immune systems have been weakened by the AIDS virus. UNAIDS estimates that TB is responsible for as many as 40% of the 3 million deaths among AIDS victims in Africa each year. It also kills many people who do not have acquired immune deficiency syndrome -- an estimated 2 million people a year worldwide.

Mandela appeared at a news conference announcing a $45-million grant from the Bill and Melinda Gates Foundation -- to the Global Fund to Fight AIDS, Tuberculosis and Malaria -- for treatment of TB. This year, the foundation donated $82.9 million for research on a vaccine against tuberculosis.

Mandela said more money was needed.

“Donors need to substantially increase their funding. This applies not only to governments, but also the private sector and private foundations,” he said. “It also applies to every global citizen -- no amount of money is too small to make a difference.”

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Mandela recounted how he had survived TB while imprisoned during South Africa’s apartheid era. He said that when he told his friends of the diagnosis, they considered it a death sentence.

Health authorities have known how to cure TB for at least 50 years, and it can be treated for as little as $10 per person, Mandela noted.

In other events Thursday, officials called for increased efforts to treat intravenous drug abusers for both their addictions and infections. Intravenous drug use is one of the main factors in the spread of the human immunodeficiency virus that causes AIDS, particularly in Russia, Eastern Europe and China.

There are an estimated 13 million intravenous drug users worldwide, said Andrew Ball, manager of HIV/AIDS support at the World Health Organization. In developing countries, as many as 90% of the users are HIV-positive, he said. “We’re looking at huge numbers of injecting drug users who are infected with HIV.”

More than 80% of the 1 million HIV-positive people in Russia are intravenous drug users, he said, and about 70% of AIDS patients in Ukraine -- which has the highest prevalence of the disease in Europe -- are addicts.

Overall, the agency estimates that drug abuse accounts for 10% of new HIV infections worldwide and a third of new infections outside Africa. But many physicians are reluctant to treat drug abusers because they view them as irresponsible people who will not adhere to treatment regimens, said Dr. Jim Yong Kim, director of the World Health Organization’s HIV/AIDS programs.

“Available data show clearly that drug users, offered the right support from the health sector, receive the same benefits from treatment as other people with HIV,” Kim said. “Yet drug users are routinely written off as unreachable and noncompliant.”


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