Respected African Union Chairman H.E. Sassou Nguesso and Heads of State and Government of the African Union:

People living with and affected by TB and HIV from over 22 countries in Africa, want to state clearly that TB is a priority advocacy issue for PLWHA in Africa. As PLWHA advocates committed to reducing the dual burden of HIV/TB in Africa we met at the First Africa Region TB/HIV Advocacy Workshop in Cape Town, June 19-21, 2006. This meeting was organized by the Treatment Action Campaign, South Africa and Treatment Action Group (TAG), New York in conjunction with the Pan African Treatment Access Movement to share information, network, and create advocacy opportunities amongst Africa-based TB/HIV advocates. As people impacted by TB/HIV and as leaders committed to alleviating the suffering caused by TB/HIV, we write to you to commend the leadership of the African Union in developing a Common Position to UNGASS on Universal Access to HIV/AIDS, TB and Malaria that was bold, engaged civil society as partners in planning, implementation, and evaluation, and included the following explicit targets for TB/HIV:

• 100% of all clients accessing HIV care and support services are screened for TB to ensure early detection and treatment
• 100% of TB patients have access to HIV testing and counseling services,
• 100% of HIV-positive TB patients access antiretroviral treatment.

As you know TB, though curable, has become a leading cause of death amongst PLWHA in Africa. The particular challenges of diagnostics and treatment of TB among PLWHA require collaborative strategies that will ensure early and effective treatment of people most vulnerable to death and disease. Besides more effective use of the current strategies, this will also need research to ensure that improved tools are available to identify TB amongst PLWHA and to treat TB and HIV concurrently. As you know the commonly used TB diagnostics will not identify TB in the majority of PLWHA as immune suppressed people are more like to have TB that is smear negative or have TB infections that are extra-pulmonary, two types of TB that is not detected through the smear microscopy. Furthermore the TB treatment that takes 6-8 months cannot be taken with many HIV medications complicates the treatment of people impacted by TB and HIV. For these reasons we believe in order for the targets set out by the Africa Common Position to be accomplished there needs to be a strong partnership between current TB and HIV health care systems, research efforts, and full engagement of PLWHA/TB activists to ensure that services, research, community education, and political will of our nations and the global community is catalyzed so as to prevent the needless deaths of PLWHA due to this preventable disease.

As civil society organizations engaged in the fight against these dual epidemics we would like to extend our hand in partnership to develop the implementation plans and garner adequate national and global resources to that will be required to create a road map to achieve these targets along with the AU in collaboration with the Regional Economic Community. We look forward to working with you on this and would like to hear from you about your plans to develop an implementation strategy to accomplish the targets set out in the Africa Common Position. Please do identify a contact person at the AU through which we will be able to work with to identify appropriate channels of strengthening this collaboration both at the level of the AU as well as on a national level. In order to facilitate an efficient means of communication we would like to offer Sipho Mthathi from our Network to act as primary contacts for this purpose.

We look forward to working together with you to ensure accomplishment of the targets of universal access for HIV and TB by 2010.

Sincerely,