Date: 15/03/2007

Source: Gauteng Provincial Government

Title: Hlongwa: World Tuberculosis Day

Speech by MEC Brian Hlongwa on the occasion of World TB Day, Kagiso Sports Complex, Krugersdorp

Honourable Executive Mayor of the West Rand District Council, Councillor Faith Matshikiza
Members of the Mayoral Committees for Health representing different municipalities in the West Rand District
Local Councillors
Head of Department of the Gauteng Department of Health
Senior Managers from the West Rand Municipalities and the Gauteng Department of Health
Chief Executive Officer of TB Free, Dr Jerry Mahlangu
Representatives of Aventis
Community Health Workers from six districts of the Province of Gauteng
Ladies and gentlemen,

Programme Director,

South Africa is one of the 22 countries with the highest burden of TB. In fact we are part of the countries that account for 80% of all cases in the world. The rate of TB infection has almost doubled in Gauteng since 1996.

This increase in the rate of TB infections is alarming when one considers that out of 100 000 people in 1996, 195 were infected with TB, and this rate of infection had sky rocketed to 444 per 100 000 in 2006 in Gauteng.

While this challenge is not unique to Gauteng alone, it is a worrying factor when one takes into consideration the resources that we as a province have.

Gauteng province covers just over 17 000 square kilometres - approximately 1,4% of the total and surface of South Africa. It is the smallest province in terms of size, but the densely populated of all the nine provinces.

Despite its size, Gauteng is home to approximately 9,7 million people. This dense population is evident in overcrowding and increase in living conditions that are not conducive to a healthy population.

These living conditions are some of the factors which contribute to the increased rate of TB infection in our province

Mphathiwohlelo,

Amazwe angenawo umnotho olingana nowalesisiFunda sase Gauteng asesimeni esingconywana mawuqhathanisa imiphumela yokulwa nesifo se TB.

Kumele sizibuze ukuthi ngabe yini le esingayenzi ngendlela uma inani labantu abaphathwa yi TB likhuphuka kangaka.

Ukuhluleka kwethu ukwelapha i TB ngempumelelo kusibeka esimeni lapho siphoqeka ukuthi sibhekane negciwane le TB elinamandla, elithatha isikhathi eside ukuthi lilapheke.

I TB eyejwayelekile ilapheka ngezinyanga eziyisithupha kuphela, kepha uma umuntu one TB engawadli amaphilisi ngokuqikelela, uzithola esephathwa yi TB enamandla ethatha isikhathi esingangeminyaka emibili ukuthi ilapheke.

Mphathiwohlelo,

Ukwelapha iTB eyejwayelekile kubiza cishe phakathi kuka u Four Hundred Rand no Seven Hundred Rand kuphela, kepha uma umuntu esephethwe yile TB enamandla kubiza cishe phakathi kuka Twenty Four Thousand Rand no Thirty Thousand Rand umuntu ngamunye uma ubala ukulaliswa esibhedlela isikhathi eside kanye nemithi ebiza ngaphezu kwale edingekayo uma kulashwa iTB eyejwayelekile.

Ngasekupheleni konyaka odlule sihlaselwe elinye igciwane leTB engalapheki, lokhu kusibeka esimeni esibucayi ngoba leTB ebizwa ngokuthi yi XDR TB ayilapheki.

Ngakhoke kumele siqikelele ukuthi izinhlelo zethu kanye namasu ethu kumele awenze umahluko.

Programme Director,

Government regards TB as a serious public health challenge, hence the Minister of Health in 1996 declared it a national priority. TB has increased at an alarming rate over the last years.

This situation has been worsened by the emergency of a new multi-drug resistant TB which has resulted in numerous deaths. TB is curable and we need to re-emphasise this message.

Even if one is HIV positive TB is still curable as long as one takes treatment as prescribed by healthcare workers.

In order to address the situation highlighted above the following issues have to be embarked on:

* heightening public awareness on the dangers of TB
* educating our people on the signs and symptoms of TB
* emphasising the importance of completing the TB treatment and consequences of failure to do so.

Drugs alone will not win us the war we are faced with. We have to reconsider the tactics that we have employed in the past in the fight against TB.

We need to strengthen community awareness because there is evidence that our people are not presenting themselves to be tested for TB earlier when they begin to show symptoms.

The fact that some of our people only come for treatment when their condition has worsened means that the burden of TB will continue increasing.

Programme Director,

I said earlier that Gauteng is the smallest of all provinces in terms of size, therefore our messages should reach our people faster, and we no longer have a serious problem of access to basic health services.

Therefore our clinics are available to test TB and treat TB.

In addition, we need to ensure that we empower our people to use the information that is at their disposal responsibly. We need re-examine our communication strategies in order to ensure that the messages we convey impacts on behaviour.

We need to reduce the stigma that is associated with TB.

Mphathiwohlelo,

Lempi yokulwa ne TB sizoyinqoba ngokubambisana nomphakathi kanye nemindeni yalabo abanezimpawu zeTB. Izinhlangano ezisebenza nomphakathini, ama NGO, amabandla ezeNkolo, kanye nabaholi bomphakathi, baneqhaza elimqoka okumele balibambe ukuze sinqobe lempi.

Izinhlelo kanye namaqhinga esinawo kumele siqikelele ukuthi anemiphumela ebonakalayo ezinhlelweni zokulwa nesifo seTB.

Kulwabiwo mali lwangonyaka odlule sabeka eceleni imali elinganiselwa no Eight Million, Three Hundred Thousand Rand ukuze silwe neTB, kulonyaka wezimali ozoqala ngenyanga ka April sibeke eceleni imali elinganiselwa no Eight Million, Five Hundred Thousand Rand ukuze silwe neTB.

Lemali engikhuluma ngayo eyezinhlelo ezilawulwa enhloko hovisi, ngingayibali leyo esetshenziswa emitholampilo kanye nasezibhedlela.

Ngonyaka odlule iSizwe Hospital yayabelwe imali elinganiselwa ku FortyOne Million Rand ukulwa neTB enamandla. Ngakhoke imiphumela yalo kwabiwa kwemali eningi kangaka ekulweni neTB kufanele ibonakale.

Mphathiwohlelo,

Emazweni azimpofana kunesiFunda saseGauteng, imiphumela ingcono kabi uma siqhathaniswa nawo. Kumele sikhuphule amasokisi sithathe izinyathelo ezinqala ekuqikeleleni lokhu okulandelayo:

* Kumele sifundise abantu bakithi ngezimpawu zesifo seTB ukuze basheshe beze enitholampilo yethu bezohlolwa. Naleyondlela sizonciphisa inani labantu abafafaza iTB bengakazi ukuthi ibaphethe.

* Kumele senyuse isivinini esihlola ngaso labo abanezimpawu ze TB ukuze basheshe baqale ukuthatha amaphilisi uma imiphumela yokuhlolwa kwabo ikhomba ukuthi banayo iTB.

* Kumele senyuse izinga lokuqoqa i-information ukuze ama �Community Health Worker esisebenzisana nawo akwazi ukulandela labo abangasezi emtholampilo bezolanda amaphilisi ngoba sebezizwa bengcono becabanga ukuthi sebelaphekile bebe bengakasiqedi isikhathi abasinqunyelwe sokuthatha amaphilisi.

* Kumele sigcizelele ukuthi iTB ilashwa mahala emitholampilo kaHulumeni.

Mphathiwohlelo,

Iqhaza elibanjwa ngama Directly Observed Treatment (DOT) Supporters iningi lawo elingama Community Health Workers kulomzabolazo wokulwa nesifo seTB limqoka kabi. Yibona abazosinceda ekuqedeni ukucwaswa okuhambisana nesifo se TB.

Lokhu kucwaswa okuhambisana ne TB kwenza abantu bengezi emitholampilo ngokushesha ngoba becabanga ukuthi kuzothiwa uma bephethwe yiTB kusho ukuthi bane HIV.

Ngithathat lelithuba ukugcizelela lokhu: Ukuthi une TB akusho ukuthi une HIV, yebo abanye abane HIV iyabaphatha iTB, kepha akusho ukuthi wonke umuntu ophethwe yiTB une HIV.

Programme Director,

When we launched the TB Crisis Plan in Gauteng on 4 August 2006, in Regina Mundi in Soweto, the Johannesburg district had already been identified as having the lowest cure rate.

At that time the cure rate stood at 62%, however the interventions that were embarked on resulted in an improved cured of up to 72,3% within a period of five months.

We can still do more to improve the overall cure rate by strengthening the overall reporting systems.

But these need collaboration with communities themselves to ensure that they adhere to treatment regimens, and report their internal migration in order to reduce the rate of treatment interruption.

Sometimes we give bureaucratic responses such as underreporting when we are asked to account for lower overall cure rates, but forget that deaths resulting from interrupted treatment, Multi-Drug Resistant strains and late detection of TB cases bear no relation to these bureaucratic answers.

Human life is at stake here, and it is largely those who are supposed to be economically active who are infected with TB.

Programme Director,

I have been reliably told that we have approximately 26 800 patients who are on Treatment, and approximately 24 000 of these are supported through Directly Observed Treatment.

Therefore, it is crucial that all of these patients should complete their treatment.

South Africa wants to see them cured!

Gauteng province wants to see them cured!

And their loved ones want to see them cured!

I thank you.

Issued by: Department of Health, Gauteng Provincial Government
16 March 2007