Date: 24/03/2006
Source: Department of Health
Title: Tshabalala-Msimang: World TB Day and Launch of TB Crisis Management Plan


  Speech by the Minister of Health, Dr Manto Tshabalala-Msimang on World TB Day and launch of TB Crisis Management Plan, Durban

Today is a very important day in the health calendar. South Africa is today joining the rest of the world in observing World Tuberculosis (TB) Day. The theme for this year’s World TB Day is: “Call for Action, Stop TB Now”.

This year’s TB Day is of particular importance to us in South Africa and in the African continent as a whole. It follows the decision of the African Health Ministers at the World Health Organisation (WHO)-Afro regional committee meeting in Maputo in August last year to declare TB an emergency. The WHO Afro member states were urged to do the following:

* Implement, with immediate effect, emergency TB control strategies and plans
* Improve TB detection and treatment success rate, and reduce patient default rates to less than 10%
* Accelerate Directly Observed Treatment Strategy (DOTS) coverage
* Rapidly scale up joint TB and HIV control activities
* Expand national public and private partnerships for TB control
* Improve the quantity and quality of the TB health workforce

South Africa participated actively in the development of this resolution. This is because we understand that TB is a major problem perpetrated by conditions of poverty, poor nutrition and inadequate housing that still affect particularly the historically disadvantaged sections of our society.

Tuberculosis is a major problem in our country; we had more than 270 000 people suffering from the disease in 2004 and at least 12% of TB patients defaulted from treatment.

The most affected provinces are Eastern Cape, KwaZulu-Natal, Gauteng and Western Cape, which contribute about 80% of the total TB burden in the country. In addition to bigger population that makes up these provinces, major factors affecting incidents of TB are:

* Lack of TB awareness and late detection of patients;
* Lack of awareness about necessity to complete treatment;
* Increasing number of patients with multi-drug resistant TB;
* Migration of patients;
* Inadequate coverage of DOTS;
* Inadequate financial and human resource support for the TB control programme;
* Poor access to laboratory.

The TB cure rate for smear positive cases remains low at 50,1% with successful treatment completion rate of 62,9%. The Medical Research Council has put multi-drug resistant TB at 6,7% of previously treated patients.

Failure to complete TB treatment poses a major challenge. Government spends R400 for treating every patient with normal TB. When these patients defaults treatment and develop a multi-drug resistant TB, the cost of treatment dramatically increases to R24 000, which includes hospitalisation and more expensive drugs.

In our determination to reverse this situation, we have developed a TB Crisis Management Plan, which we are launching today.

The TB Plan identifies four districts with both high number of TB cases and low cure rates. These districts are Amatole and Nelson Mandela Metropole in the Eastern Cape, City of Johannesburg and eThekwini Metro.

We have also selected KwaZulu-Natal and Eastern Cape as two provincial focus areas for the enhanced interventions against TB.

The key elements of the plan focus on strengthening of TB service delivery systems and processes and an intensive communication and social mobilisation campaign.

The aim is to increase the smear conversion rate in the short term and the cure rates in the medium term in these districts and provinces. Each province will be responsible for addressing the following critical issues:

* Making adequate financial and human resources responsible for TB available at all levels (provincial, district and facility);
* Ensuing access to laboratory services; * Strengthening of the TB reporting and recording system;
Referral systems to ensure proper treatment and follow-up of transferred patients and patients requiring treatment for co-infections;
* Implement highly visible social mobilisation and media campaign
* Strengthen supervision system to ensure facility and community-level health workers receive adequate mentoring and support.

Our goal is to ensure that every TB patient is detected and supported during the entire period of at least six months whilst on TB treatment to ensure that they get cured.

As government, we are committed to mobilising the necessary resources to ensure that the TB Crisis Management Plan we are launching today is implemented and we reverse the tide of TB in the country.

We want to ensure that all South Africans understand the challenge of TB and at least know the symptoms of the disease. These include:

* Coughing for more than weeks;
* Sweating at night;
* Loss of weight;
* Loss of appetite;
* And tiredness.

We are here today to call our community into action. Any person who shows these symptoms should visit the nearest clinics to get checked. If you get diagnosed with TB, please take and complete you treatment even if you are feeling better. All of us should encourage people with symptoms to seek medical advice. Let us support people with TB to complete their six-month treatment.

Today we are all saying: Hhola Six.

Issued by: Department of Health
24 March 2006