Dear Drs Piot and Raviglione,

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. We write to UNAIDS and the Stop TB Department as part of this advocacy to raise three topics:

1. To underscore need for UNAIDS and Stop TB Department to accelerate and strengthen your collaboration,
2. To voice our dismay over the UNGASS Declaration of 2006 and identify ways to build of the gains made for TB/HIV within that Declaration, and
3. To urge UNAIDS and Stop TB Department to leverage all their resources in support of the implementation and success of African Union's Common Position to the UN General Assembly Special Session on AIDS in June 2006 on the theme of "Universal Access to HIV/AIDS, Tuberculosis and Malaria Services by 2010."

1. The Need for UNAIDS and Stop TB Department to Accelerate and Strengthen Collaboration.
   We, TB/HIV activists support the improved communication between UNAIDS and the Stop TB Department. Yet, there is much more to be done and we urge UNAIDS and the Stop TB Department to work in greater collaboration on TB/HIV issues so that policies and services for communities infected and affected by TB and HIV are developed in a manner that leads to effective collaborative planning and implementation of TB/HIV activities both at the global and national level.

   Building upon the previous efforts of our TB/HIV comrades, spearheaded by Chris Green from Indonesia in sending a similar request to you when they had met at TAG's 4th TB/HIV Advocacy Workshop in conjunction with the Union Conference in October 2005; we TB/HIV from 22 countries from Africa would like to establish mechanisms through which we are are informed and can be a support to the implementation of the following commitments that UNAIDS and the Stop TB Department had made in December 2005 to TB/HIV activists:

   • Have regular dialogue between Stop TB Department and UNAIDS
   • Mainstream TB into UNAIDS activities and department including the UNAIDS 2006 report
   • Incorporate TB into HIV/AIDS materials and courses
   • Engage Dr Peter Piot in World TB Day 2006
   • Collaborate in ensuring that TB/HIV is fully addressed in IAS 2006
   • Longer term strategy that included secondment of staff from Stop TB to UNAIDS.

   We are disappointed that though there was increased attention on TB/HIV during the World TB Day 2006, we did not see the involvement of Peter Piot in these efforts, and also would like to see TB/HIV integrated into the main program of IAS, rather than the pre-conference and satellites that are being currently planned. TB is a leading killer of PLWHA globally—no HIV conference should happen without adequately addressing this central fact in a significant way. It has been more than 6 months since the above commitments and we demand that the UNAIDS move quickly to second a staff from the Stop TB Department to provide a clear mode of communication and focus for TB/HIV activists to work through.

   As TB/HIV civil society members that are monitoring the implementation of the above commitments we would like to consistently mode of communication to be updated on the activities that are accomplished through them so far as well as your plans to build upon these activities into the future and offer our partnership in furthering these efforts.

2. Build on the gains made for TB/HIV in the UNGASS Declaration 2006
   We TB/HIV activists were dismayed by the complete absence of any high level Stop TB Department leaders presence at UNGASS. We also share the grave concerns of many other HIV activists that the Declaration of Commitment issued at the June 2006 UNGASS review has shied away from setting targets that would have been vital for national governments and civil society organizations to develop credible plans that are accountable and measurable. As a small gain, we are pleased with our accomplishment of the inclusion of the language of TB/HIV in the UNGASS commitment number 33 stating:

   "Emphasize the need for accelerated scale-up of collaborative activities on tuberculosis and HIV in line with the Global Plan to Stop TB 2006-2015 and investment in new drugs, diagnostics and vaccines appropriate for people with TBHIV co-infection".

   We hope that in the plans to monitor the UNGASS Declaration of Commitment, national governments and civil society will utilize the targets outlined in the Global Plan to Stop TB 2006-2015 to ensure that the letter and spirit of UNGASS is fulfilled leading to the Universal Access for HIV and related opportunistic infections by 2010.

3. UNAIDS and Stop TB Department Support of the Implementation of African Union's Common Position on Universal Access to HIV/AIDS, TB and Malaria by 2010.
   We as civil society institutions fighting to alleviate TB/HIV in Africa are proud of the leadership displayed by the African Union in developing the Africa Common Position to UNGASS on AIDS in June 2006. We wholeheartedly support the targets laid out by the African Union's Common Position that include the following commitments 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.

   We hope that UNAIDS will leverage all its resources to ensure the successful implementation of the targets outlined in African Union's (AU) Common Position. As advocates in the leadership of PLWHA communities invested in addressing TB/HIV, we commit to partnering with our leadership through the framework of this AU Common Position to support the implementation, monitoring, and evaluation of the commitments outlined in this document.

In order to facilitate communication between our network of TB/HIV activists and your institutions we are invested in the success of your collaborative efforts and civil society organization would like to have a consistent mode of communication to develop this partnership further. In order to facilitate this communication, we have identified Nomfundo Eland to serve as the lead contact from our network with your organizations. Please contact Ms. Eland to provide us updates on the implementation of the agreements between UNAIDS and Stop TB, to clarify how the TB/HIV targets from Global Plan 2006-2015 will be utilized to monitor the 2006 UNGASS declaration, as well as the role of UNAIDS and Stop TB Department to ensure the successful implementation of the African Union Common Position Statement.

We look forward to hearing from you and working with you to increase political will and effective strategies to ensure that PLWHA do not die of a treatable disease like TB.

Sincerely,