Nelson Mandela came to the 15th International AIDS Conference here Thursday
to lend his prestige to the battles against Tuberculosis and AIDS, two
deadly diseases that are intricately linked.
The former president of South Africa was diagnosed with Tuberculosis while
in prison, where he spent 27 years for opposing the Former apartheid regime
before his release in 1994.
"We cannot win the battle against AIDS if we do not also fight TB,"
Mandela said at a press conference on Thursday. "TB is too often
a death sentence for people with AIDS."
Mandela has acknowledged that, as president, he did not recognize the
severity of the AIDS epidemic in South Africa, which now leads the world
with 5.3 million people infected with HIV, the virus that causes the disease.
Since Mandela left office, he has embraced the fight and has pushed his
successor, Thabo Mbeki, to confront HIV and tuberculosis.
Tuberculosis causes from 15 percent to 50 percent of deaths Among HIV-infected
people, making it the leading cause of death among people with AIDS, according
to the World Health Organization.
While the AIDS virus and the tuberculosis bacterium each can cause fatal
illness, the two diseases can form a deadly combination, each amplifying
the other's progress. By weakening the immune system, the AIDS virus leaves
infected people particularly vulnerable to developing tuberculosis.
Mandela said he spoke about his case of tuberculosis because he felt that
the disease was ignored and to help the Bill and Melinda Gates Foundation
open a $44.7 million program to conduct research to develop strategies
to control tuberculosis in communities where HIV is highly prevalent.
Mandela said prison doctors diagnosed his case of tuberculosis by testing
his sputum. "Fortunately, we sent the specimen before there were
holes in the lung," Mandela said.
After doctors told Mandela that it would take four months to cure his
tuberculosis, he told his friends in prison about the diagnosis. He said:
"My friends objected to me sharing my personal affairs. But I consoled
them and told them that the doctors and hospital staff knew about my status
and I therefore had no reason to hide this information from those close
Mandela said he took the same steps of disclosing his more recent case
of prostate cancer. "I knew that once people were aware of the effects,
they would support me," Mandela said. "I'm convinced that the
support of my family, friends and the public in general contributed to
my healing process."
Mandela said it was a blessing that "the world has made defeating
AIDS a top priority." But an additional fight against tuberculosis
is required, he said. The problem, said Dr. Richard Chaisson of Johns
Hopkins University in the United States, a recipient of one of the new
Gates grants, is "a catastrophic collision of two epidemics."
Determining whether tuberculosis or HIV caused the death of a person with
AIDS can be difficult and depends on specific medical facts in each case.
Because such determinations involved medical judgments, the percentage
of deaths caused by tuberculosis has varied widely in different studies.
Tuberculosis was widely prevalent even before the AIDS epidemic began
to take hold in 1981. But now more people are dying from tuberculosis
worldwide than ever, the UN says.
In sub-Saharan Africa, where 25 million people are HIV-infected, two-thirds
of tuberculosis patients also have the AIDS virus. And of the estimated
1.6 million deaths that tuberculosis causes each year
worldwide, one-fourth occur among HIV-infected people. Worldwide, as many
as 50 percent of HIV-infected people develop tuberculosis.
Treatment of tuberculosis can prolong and improve the quality of life
for HIV-infected people, but cannot alone prevent people from dying of
AIDS. The current strategy for managing tuberculosis in poor countries
generally depends on patients seeking care and aims at treating patients
with active tuberculosis, not those with silent infection.