Venter argued that patients with tuberculosis, despite their high rates of death and suffering, do not enjoy the same level of health services and treatment as HIV patients.

‘€œIn South Africa, [TB patients] can look forward to late diagnosis, inadequate adherence counselling and support, and they are not going to be told about the side effects,’€ said an openly upset Venter.

‘€œThey are going to get DOTS [Directly Observed Treatment Short Course] thrown at them, and because of DOTS, many of them are going to lose their jobs. They are going to have low cure rates, and they are going to be taking very toxic drugs,’€ Venter continued. ‘€œAnd in my country [South Africa] there is a chance of being incarcerated if they are stupid enough to present themselves as a drug-resistant patient who says that they prefer not to be hospitalised.’€

In his presentation, Venter made a passionate plea to the international community of lung health experts and policy makers to integrate HIV and TB health services.

Venter argued that there have been some great scientific advances and breakthroughs in HIV research, such as the microbiocide gel research and preventative therapies using antiretrovirals. However, the same cannot be said for TB, where science has made little progress in the last few decades.

HIV also has highly accurate diagnostics that delivers same-day results. ‘€œEven in the poorest regions in South Africa you can still get a good HIV test,’€ said Venter. Until recently, it took between two and six weeks for a South African patient to get the outcome of a TB test. Earlier this year the GeneXpert TB diagnostic machine, that provides certain results within two hours, was released, but it is still being rolled out in the South African health system.

Venter also commented on the quality and availability of drugs for the two diseases. ‘€œIn the treatment for HIV, if there are new drugs, they get to market rapidly. In TB [the latest drugs] have been wandering around for 10 years, but it’€™s still not generally available,’€ said Venter. Although there are robust second-line treatment for drug resistance in HIV, Venter argues that second-line HIV therapy is a lot less toxic and first-line TB therapy. ‘€œAnd the toxicity is so severe for MDR and XDR [TB] treatment, that you practically have to hospitalise the patients to manage the side effects.’€

The DOTS treatment regime, where a patient has to take their medicine in front of an allocated person every day, was also criticised by Venter. ‘€œIt is one of the most patronising patriarchal programmes I have come across… we have evidence in HIV to show that individualised counselling that has been tailored around the patient, have better outcomes than the DOTS programme.’€  

Other areas in which TB lagged behind HIV that Venter highlighted were in treatment outcome, monitoring and infection control.

Lastly Venter argued around the lack of activism for TB. ‘€œIn HIV we have decent activists. People get stuck in, they argue, and they don’€™t take prisoners… Where is that [activism] coming from the TB world? Anger [is required from activists] to take this forward.’€

‘€œThis is about lack of attention because it is about poor people. People say: ‘€˜There is no money’€™. But I cannot understand how we can so easily use a term like that while so many people are dying.’€