According to the World Health Organization sponsored “Stop TB” initiative, two million people die every year from tuberculosis. Ivy Appolis, Coordinator of AIDS Care Program of the St. Francis Hospice in Port Elizabeth, South Africa, reported at the CCIH conference that one third of AIDS Hospice patients have TB. This fact is supported by research done by WHO, Stop TB, UNAIDS, and the World Bank who further reported the following association between TB and HIV/AIDS in a fact sheet prepared for the occasion of World’s AIDS Day on December 1, 2000:

    ●    Tuberculosis is a leading killer worldwide of people with HIV/AIDS.

    ●    Sub-Saharan Africa and South-East Asia are the regions most badly affected by the global TB/HIV co-epidemic: 68% of those co-infected live in sub-Saharan Africa; 22% live in South-East Asia.

    ●    Up to 70% of patients with sputum smear-positive pulmonary TB (the infectious form of TB affecting the lungs) are HIV-positive.

    ●    Up to 50% of people with HIV/AIDS develop TB.

    ●    HIV fuels the TB epidemic. HIV promotes rapid progression of primary TB infection to active disease and is the most powerful known risk factor for reactivation of latent TB infection to active disease. (1)

The reality of these alarming figures was brought home to participants at the CCIH conference by four presentations addressing community-based approaches to TB control, community-based DOTS (direct observation treatment short-course), church hospital role in TB control, and involvement of hospice in TB control. Brief abstracts of the presentations are contained in this special volume of abstracts from the CCIH conference.

The church has been on the forefront of TB control, in many cases pioneering and showcasing the volunteer-intensive DOTS programs. Godfrey Biemba presented the work of CMAZ (Churches Medical Association of Zambia). One of their members, the Ndola Catholic Diocese in Zambia, has been involved in DOTS and HIV/AIDS home-based care programs since 1991. The continuing program has grown to cover 450,000 with the assistance of 750 community volunteers and 34 nurses. Frank Dimmock presented how Presbyterian Church hospitals in Malawi are testing the Zambia DOTS model in 5 of the 26 districts in which they are active.

The church is uniquely placed to be instrumental in the fight against TB. It has an established religious mandate to help the poor and needy, and to visit the sick. It also has a history of helping in long-term crises and has a proven longevity and sustained presence which adds stability to this type of program and renders it less vertical. The DOTS program is a natural outreach opportunity for the church. It works because of the relationships that are built between volunteers and those needing assistance. The volunteers get to know the sick person and his/her family and their environment. In addition to the physical administering the TB drugs and observing that the medicine is swallowed, the important aspects of touch, physical support, compassionate listening, and spiritual accompaniment are integrated into a holistic response to the sick person. At these times, the gospel is an encouraging word, a cup of cold water, a meal, a tender touch.

When Anti-Retroviral (ARV) therapies for the treatment of AIDS become widely available in the developing world, the DOTS program will undoubtedly be a model for their distribution and administration. Will the church seize the opportunity to help the poor, the needy, and the sick and enter into positive caring relationships with persons living with HIV/AIDS and their families? Will we be the “aroma of Christ” to those who are perishing?

(1) World AIDS Day 1 December 2000: TB/HIV: THE FACTS. http://www.stoptb.org/world.tb.day/WTBD_2001/FactSheet.TBHIV.htm (10 October 2001).

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Selected Tuberculosis web links:

 

    •    Stop Tuberculosis: www.stoptb.org
    •    WHO TB Prevention and Control:  www.who.int/gtb
    •    Centers for Disease Control: www.cdc.gov/nchstp/tb
    •    Int’l Union Against Tuberculosis & Lung Disease : www.iuatld.org