Speech by Free State MEC for Health Mr Sakhiwo Belot at the tuberculosis (TB) indaba, Ilanga Estate, Bloemfontein

Programme director
Honoured guest
Ladies and gentlemen:

We are all gathered here today to join hands in the Active TB Free State Indaba. Today's event is of critical importance to the Free State Department of Health because it demonstrates the strength in collaboration and partnership between the public and private sector communities.

We are all conscious of our situation with regard to TB infection. We have identified the importance of this Indaba here today as it has become necessary that we promote the health of our people in the community by raising awareness of health issues such as TB, and share among ourselves experiences and wisdom.

It has also become necessary that we make people aware of the importance of reporting one's movement to their health facility whilst still on TB treatment; this will assist us in an event of tracing contacts.

Ladies and gentlemen, allow me to remind us of the Free State TB Control Programme's crisis plan.

It aims at:
* flooding the communities with messages and activities to increase awareness
* implementing emergency strategies from the crisis plan to control the worsening tuberculosis epidemic
* rapidly improving tuberculosis case detection and treatment success rates
* expanding provincial partnerships for TB control, especially with the mining sector; correctional services and
* implementing strategies to reduce patient default and transfer out rates to 10 percent or less.

The programme faces some challenges as patients present late at our health facilities due to a lack of awareness about the disease and the stigma associated with TB. There is also poor adherence to treatment, which is a result of lack of understanding of the importance of complying with the treatment prescribed.

We have also found a low conversion rate of the positive smears at two or three months because some people are reluctant to submit their sputum specimens for testing for fear that if they should test negative they will forfeit their disability grant. We would like to advise people about the importance of submitting sputum specimens for follow up because this is the only way that the nurses will be able to tell if the TB medication you are using is effective or not. TB is not a disability and people who do not take their medication are putting their families and other community members at risk.

There has been significant progress in the detection of TB cases in the Free State after the implementation of the active case finding campaign in 2005. The TB Control Programme at district and provincial level still has a problem in ensuring that people with the confirmed TB disease adhere to treatment until completion.

One of the achievements in 2006/07 is the training of managers and doctors from both the public and private sectors in the control and management of tuberculosis. This includes also the doctors and nurses from the mining industry.

Ladies and gentlemen, I have to mention the important role of the DOT supporters. This group of men and women:
* conduct continuous awareness within communities through door-to-door campaigns
* supervise the TB patients when taking the medication; and most of all
* give support and encouragement to the TB patients until they complete the six months' treatment period.

We would like to encourage people who have been diagnosed with TB to complete their treatment. Failure to do this will result into a serious condition known as Multi-drug Resistance TB (MDR-TB). The treatment of MDR-TB takes longer, is more difficult and expensive.

As communities it is our responsibility to support those on treatment, to advise those coughing longer than two weeks to go for sputum tests, and to report to our healthcare workers anyone who refuses to go for tests or whom you know is refusing to go for treatment. As individuals we are the only ones who can stop all TB. TB is preventable and can be cured free of charge with the resources offered by the government.

Programme director, in conclusion, elements of poverty such as poor living conditions and malnutrition predisposes people to being infected with TB and the rapid development of infection to disease as a result of depressed immune system is a real reality. I would therefore like to encourage members of the community and community structures to form strengthen support groups and partnerships. Government cannot fight the battle alone; we need the help of each individual to ensure a healthy and self-reliant Free State community.

I thank you

Issued by: Department of Health, Free State Provincial Government
27 September 2007