Aiding a disaster

Along with problems associated with unhealthy living conditions and drug resistance, tuberculosis poses an additional danger as it has targeted HIV carriers. As such, TB is a leading cause of death due to a single infectious agent. In the developing world, the annual incidence of all forms of TB is 7.3 million.

Recognising TB as one of the world's most neglected diseases, WHO declared it as a global emergency in April 1993. WHO projects that nearly 90 million new cases of TB will emerge over the next decade, and 1/3rd of them will be fatal unless steps are taken to check the disease.

According to an Union health ministry document, the rise in TB in India due to HIV will be a trident attack:

1) By reactivating pre-existing TB infection in HIV-infected persons

2) By new infection with TB and direct progression to TB in HIV-infected persons

3) By creating additional cases in the general population whose infection originates from HIV-positive TB patients

Another significant phenomenon is the connection of kala-azar and AIDS. TDR programme researchers have noticed the appearance of visceral leishmaniasis in individuals infected with HIV but without a history of leishmaniasis.

So far, the problem seems to be limited to Europe. As HIV is largely an urban problem and kala-azar a rural one, so far their interplay has not been a major problem. However, the TDR programme review report notes, "As HIV infection spreads to rural areas, the danger of leishmaniasis as an opportunistic disease becomes apparent."