Drug-resistance surveillance Containing and countering drug- resistance (including rational use of second-line treatment regimens) Despite recent progress, insufficient laboratory capacity in countries most badly affected by HIV and by tuberculosis for surveillance of resistance to antiretroviral [46] and antituberculosis [13] drugs Failure to contain the spread of drug-resistance [46,49] Research and development for new diagnostics, drugs and vaccines Inadequate development of new diagnostics, drugs and vaccines, especially for tuberculosis [51] Global advocacy for resources Global partnership Joint support of development of national and international capacity for drug-resistance surveillance, including resistance to antiretroviral and antituberculosis drugs Supporting health system capacity to contain drug- resistance, by learning mutual lessons from experiences in HIV and tuberculosis treatment Joint support of advocacy for increased funding, and for development of platforms, for research and development Joint advocacy for funding of strong health systems which are able to respond effectively across a range of disease priorities and benefit from synergies of approaches to different diseases Maher BMC Public Health 2010, 10:394 http://www.biomedcentral.com/1471-2458/10/394 Page 9 of 11 Table 5: Examples of programme activities where joint efforts for HIV and for tuberculosis epidemic control can be better integrated into a strengthened health system (Continued) Improved health system capacity for drug-resistance surveillance, including resistance to antiretroviral and antituberculosis drugs Improved health system capacity to contain resistance to drugs used in treatment of a wide range of diseases More efficient and effective health system contribution to development of new technologies for disease control More effective health system based on funding of disease control commensurate with the burden of disease More effective and efficient roles played by partners in global health partnerships and in global HIV and tuberculosis partnerships Competition between advocates promoting resource mobilisation for different diseases Failure to maximize synergies and Joint support of global avoid duplication and dispersion partnerships which embrace joint of effort among partners HIV and tuberculosis issues (e.g. Global Fund for AIDS, Tuberculosis and Malaria) and of more cohesive global HIV partnerships, learning from lessons of the global Stop TB Partnership [58] • Despite recent progress, collaboration between HIV and tuberculosis remains inadequate, progress in obtaining synergies has been slow, and results remain far below those needed to achieve the goal of univer- sal access to key interventions. • International and national health agencies should review policies and progress in epidemic control of HIV and tuberculosis, with the aim of identifying syn- ergies: learning mutual lessons for policy develop- ment and for scaling up implementation of interventions and identifying ways of joint planning and joint funding of integrated services as part of strengthened health systems. • The silver lining in the global economic crisis could be better control of the HIV and tuberculosis epidem- ics, better overall health system performance and out- comes, and better value for money. Competing interests The author declares that they have no competing interests. Authors' contributions I am the sole author Acknowledgements I am grateful to Anthony Harries for his helpful contribution in reviewing the manuscript. Author Details Medical Research Council (MRC)/Uganda Virus Research Institute (UVRI) Uganda Research Unit on AIDS, PO Box 49 Entebbe, Uganda Received: 28 November 2009 Accepted: 5 July 2010 Published: 5 July 2010 TB©hM2iCs0ai1Psr0utaibMnclieOachiHpsearn;vlaAtchielac2nbe0sl1es0fa,rB1oti0mocM3l:h9e4tdispCt:re/inbwturwtaelwdL.tbudino.dmerdthcenetraml.csomft/h1e47C1re-2a4ti5v8e/1C0o/m39m4onsAtributionLicense(htp:/creativecommons.org/licenses/by/2.0),whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. References 1. Lopez AD, Mathews CD, Ezzati M, Jamison DT, Murray CL: Global burden of disease and risk factors New York: Oxford University Press, Washington, DC: World Bank; 2006. 2. Maher D, Harries A, Getahun H: Tuberculosis and HIV interaction in sub- Saharan Africa: impact on patients and programmes; implications for policies. Tropical Medicine and International Health 2005, 10(8):734-42.