SA: Paul Mashatile: Address by Deputy President, during the World TB Day commemoration and launch of the National Strategic Plan for HIV, TB and STIs, Tlhabane Stadium, Rustenburg, North West Province (24/03/2023)

24th March 2023

SA: Paul Mashatile: Address by Deputy President, during the World TB Day commemoration and launch of the National Strategic Plan for HIV, TB and STIs, Tlhabane Stadium, Rustenburg, North West Province (24/03/2023)

Deputy President Paul Mashatile

Programme Directors (North West Health MEC Madoda Sambatha & Provincial Civil Society Chairperson Mr Pinampi Maano);
Minister of Health, Dr Joe Phaahla;
Chairperson of the SANAC Civil Society Forum, Ms Steve Letsike;
Chairperson of the SANAC Private Sector Forum, Dr Tshegofatso Gopane;
Our gracious host, the Premier of the North West Province, Mr Bushy Maape;
Our esteemed Traditional and Khoi-San Leaders present
US Consul General in South Africa, Mr Vincent Spera,
Esteemed members of the US Government delegation;
UNAIDS South Africa Country Director, Ms Eva Kiwango;
WHO Country Director, Dr. Owen Kahlua,
Esteemed members of the UN Delegation;
Leaders of our Inter-Faith Communities;
Other Development Partners here present;
Cosatu President, Ms Zingiswa Losi;
SANAC CEO, Dr Thembisile Xulu;
Members of the Media
Honoured Guests, fellow South Africans,

Dumelang! Sanibonani! Avhuxeni!

On behalf of the SANAC Community, I would like, first and foremost, to convey my sincere gratitude to former Deputy President David Mabuza for the leadership he provided as Chairperson of the South African National AIDS Council as well as leading the process towards the National Strategic Plan 2023-2028 that we are launching today.

His vision and leadership helped to forge stronger ties with key partners in the fight to end HIV/AIDS and Tuberculosis.  These valued partners include our esteemed Traditional and Khoi-San leaders, the business community and civil society. His efforts ultimately ensured that all sectors join and put all their efforts to make the SANAC family a success. We must continue to strengthen collaboration with all national and international stakeholders.

As all of us are aware, tuberculosis remains one of the leading causes of ill health and death in South Africa. This is exacerbated by the fact that some TB patients do not complete their treatment while others remain “missing;” which means that they are either undiagnosed or are unreported even as they are diagnosed. 

Today, our country joins the rest of the world in observing World TB Day under the country theme: “Yes! You and I Can End TB!” The theme is aimed at encouraging individual action to strengthen the national strategy against Tuberculosis. It underlines the significance of taking personal responsibility and joining forces to eradicate Tuberculosis as a public health threat by 2030.

We must recommit ourselves to raising greater levels of awareness about the disease alongside its terrible health, social, economic implications and strengthen other efforts to prevent the further spread of the disease in our communities.

This province faces specific challenges in the fight against Tuberculosis due to mining activities and a high number of informal settlements which result in overcrowding and unfavourable living conditions which expose people to health hazards.

However, the province has made noteworthy progress in the reconstitution of its Provincial Council on Aids with the involvement of all stakeholders. Other provinces can learn valuable lessons from this positive step.

The Government is determined to build a world free from the devastation of preventable and curable diseases such as TB. We must continue to embark on Tuberculosis catch-up programmes as we continue to pursue shortened treatment after infectious diseases took a backseat due to the COVID-19 pandemic.

However, regardless of the setback, we have made conscious efforts to rebuild and intensify TB interventions across the country.

Through the ‘You and I” statement of intent, we seek to encourage individuals to take charge of their health in line with the objectives of the “Cheka Impilo” National Wellness Campaign, as well as the country’s endeavour towards finding the Missing TB Patients.

It is critical that everyone infected with TB is aware of the infection, is introduced to treatment and goes on to complete their treatment. Finishing the course is important in order to avoid developing Multidrug-resistant TB and Extensively drug-resistant TB which are both very difficult to treat, life-threatening and fatal. 

We must promote awareness for personal responsibility in the eradication of TB.  This will undoubtedly deliver better progress in the fight against TB. Together, we can recover the ground lost by the TB response as a result of the COVID-19 pandemic.

We should bear in mind that our country is mostly off-track in terms of attaining the set TB targets, including those related to the 2018 United Nations High-Level Meeting on TB.

It concerning that the last SA TB Prevalence Survey positioned our country as one of the 30 high TB burden countries accounting for 87% of the burden. It is one of 10 countries with a triple burden of TB, TB/HIV and MDR-TB.

We shall accelerate interventions to eliminate TB by fast-tracking the implementation of the TB Recovery Plan launched in 2022.

We have already started finding undiagnosed people with TB through interventions that scale up community screening, introduce Targeted Universal TB Testing, and the use of other technologies.

One of the useful approaches to mobilising political will for TB response, is the strengthening of the South African TB Caucuses in all our Provincial Legislatures. The Caucuses provide a platform for elected public representatives to champion the TB response in their provinces and constituencies, led by the Speakers of the Provincial Legislatures.

We are pleased to report that five out of the nine provinces have successfully launched their TB Caucuses.  These are the North West, Gauteng, Limpopo, Mpumalanga and the Western Cape Provinces. The National TB Caucus in Parliament is due to be relaunched this year. We congratulate all these provinces and urge the remaining others to follow suit. 

A few days ago, we observed the Human Rights Day. As we continue to observe Human Rights Month, we should remember that access to health care services is a basic human right guaranteed by our Constitution.

Stigma and discrimination remain some of the hardest social and structural barriers that limit access to TB screening, treatment and care – thus compromising the lives of people who are infected and affected by TB. We think it is unacceptable that in year 2023, we are still talking about stigma!

We should therefore collectively champion interventions against social isolation associated with TB at community level. We must also continuously maintain well-coordinated multi-sectoral interventions against stigma and discrimination in our communities.

We will continue to work together to look at how to strengthen the systems that link people to care, strengthen the systems that keep them in care, and scale up initiatives that encourage the use of TB prevention therapy.

In September this year, world leaders will gather at the United Nations General Assembly for the United Nations High-Level Meeting on TB. The last meeting was held in 2018 during South Africa endorsed the Political Declaration on TB.

Key among the targets committed to in that declaration were the following:

Treat 40 million people with TB between 2018 and 2022;

Treat 3,5 million children with TB;

Treat 1,5 million people with drug-resistant TB; and

At least 30 million people put on TB Preventive Treatment.

We cannot over-emphasise the importance of collaboration in the TB response. We can do more by leveraging our combined strengths and resources.

The active roles of civil society, private sector, development partners, research institutions, community members, TB survivors and people infected with TB, all remain paramount in our fight to end TB.

To that effect, through the fourth National Strategic Plan (NSP), we continued to guide our collective response to HIV, Tuberculosis and Sexually Transmitted Infections. Viewed together, the plans set out in the NSP provide insight into the path we have travelled as a nation to overcome one of the most devastating human challenges of our time.

The previous NSP is a clear demonstration of the outstanding progress we have made. It is also a stark reminder of how far we still need to go.

Indeed our response to HIV, TB and STIs has evolved over the last two decades as we have come to understand the nature and impact of the epidemics, the factors that contribute to their spread, and the interventions that work best in reducing infection, morbidity and mortality.

In this regard, we are pleased to launch today the fifth National Strategic Plan for HIV, TB and STIs for the period 2023 to 2028 as adopted by Cabinet.

The new NSP is a blueprint and roadmap for a multi-sectoral, people-centred approach to eliminate HIV, TB and STIs as public health threats by 2030.

It emphasises the need to break down barriers and maximise equitable and equal access to services, through resilient and integrated health systems, to guarantee the health and social protection of all South Africans.

The successful implementation of this NSP will require strong governance and leadership, and the involvement of all sectors of society including government, business, organised labour, civil society, development partners, research institutions and communities in general.

The 2023- 2028 NSP features four strategic Goals:

Goal 1: To break down barriers to achieving HIV, TB and STIs solutions.

Goal 2: To maximise equitable and equal access to HIV, TB and STIs services and solutions.

Goal 3: To build resilient systems for HIV, TB and STIs that are integrated into systems for health, social protection, and pandemic response.

Goal 4: To fully resource and sustain an efficient NSP led by revitalised, inclusive, and accountable institutions

Work has already begun to give effect to these goals. SANAC is leading several activities as part of the NSP rollout.

One of them is the year-long Sexual and Reproductive Health and Rights (SRHR) Campaign – aimed at sustained and impactful messaging and demand creation for reproductive health services, information about STI transmission, condom use, availability of family planning services and availability of ground-breaking HIV prevention tools such as the newer Dapivirine Ring as pre-exposure prophylaxis (PrEP).

Another project in the pipeline is the Treatment Literacy Framework aimed at improving treatment adherence, eliminating stigma & discrimination, promoting health seeking behaviour and enhancing treatment uptake.

This is important to ensure that individuals on antiretroviral therapy remain virally suppressed so that they can enjoy a good quality of life. Most importantly, when the viral load is undetectable, HIV cannot be passed onto one’s sexual partner.

SANAC is also preparing for the launch of the “Situation Room” – a cutting-edge data visualisation and analytics platform that provides up-to-date multi-sectoral data in an easy-to-use format to support evidence-based decision making and planning.

Another critical signature initiative by SANAC is the continued effort to strengthen the Provincial AIDS Councils. The core objective of all this work, is to pave the way for the successful implementation of the NSP.

The NSP 2023-2028 calls upon all of us to build consensus and drive a well-coordinated, unified response to the three epidemics over a five-year period.

We must also be cognisant of the fact that this is the last NSP ahead of the 2030 target of ending HIV and TB as a public health threat, and we dare not fail.

Drawing lessons from previous NSPs, the COVID-19 pandemic and current epidemiological trends, the new NSP is considerably more radical in its own right –

It is pandemic-ready to guard against unknown future disruptions similar to those caused by COVID-19,

It recognises the need to strengthen health systems, 

It has an expanded scope for the management of sexually transmitted infections.

It recognises the need to scale up mental health services and social support based on interlinkages between HIV, TB, and STIs with other social challenges such as gender-based violence and femicide (GBVF), human rights violations and inequalities.

It was drafted through an extensive public consultation in all nine provinces by bringing together multiple stakeholders, key populations, vulnerable groups, academics and ordinary people from all walks of life.

Every input was carefully considered and integrated into the final product, the NSP 2023-2028 that we are launching today.

SANAC will coordinate the implementation of the NSP as mandated by Cabinet; however, its successful implementation lies with all of us.

It is about our lives, how we protect it, how we prolong it, how we value it and how we improve it. Let us work together to ensure that this NSP is one of the last in our times.

Yes we can conquer TB!

Yes TB is curable! And

“Yes! You and I (Together) Can End TB.”

I thank you.