One patient, two diseases: collaboration in controlling TB and HIV in the Free State

Abstract

A perilous synergism exists between TB and HIV/AIDS, which form a dual epidemic requiring joint action. This paper first reviews key global and South African policy developments in relation to TB-HIV/AIDS control. Secondly, the early response of the Free State to global and national directives to implement integrated TB-HIV/ AIDS programmes is described. As is clear from the experience of the first TB-HIV training site in the Free State, the Mafube local municipality, integrated TB and HIV/AIDS control is made possible by means of actual practical interventions as well as the collaboration of a range of role-players. In Mafube, and later also in the Free State at large, attempts at integration have resulted in substantially more TB patients undergoing voluntary counselling and testing for HIV.