Address by Deputy President Cyril Ramaphosa to mark World TB Day, Marapong Stadium, Lephalale
The AU Commissioner for Social Affairs, Dr Mustapha Kaloko
Minister of Health, Dr Aaron Motsoaledi,
Premier of Limpopo, Mr Stanley Mathabatha,
Mayor of Lephalale Municipality, Cllr Jack Moloko Maeko,
MEC for Health in Limpopo, Dr Phophi Ramathuba,
The leadership of SANAC,
Our local and international partners in the fight against TB,
Distinguished Guests, Ladies and Gentlemen,
We meet here in Lephalale as countries across the globe prepare to mark World TB Day on the 24th of March.
This is a joint commemoration with the African Union, demonstrating our shared responsibility to work together to end TB across the continent.
We meet here strengthened and encouraged by the international recognition that South Africa has received as a leader in the global fight against tuberculosis.
A few days ago, our Minister of Health, Dr Aaron Motsoaledi, who is also the Chair of the global Stop TB Partnership Board, was accorded the USAID-TB International Award.
This award recognises his outstanding and committed leadership in the worldwide fight against TB.
We congratulate him on this honour, which is a tribute to his success in raising the profile of our nation’s health and advancing the wellbeing of people across the world.
The Minister can be assured that we, the South African National AIDS Council, have heard his clarion call that the world must prioritise and pursue with greater urgency the fight against TB.
As SANAC, we know only too well that our country will never win the battle against HIV and AIDS if we do not also prioritise the detection and treatment of TB.
Together with our social partners and development agencies, we will continue to remind our people that TB can be detected, treated and cured.
We will continue to remind them that the means to overcome this disease are readily available.
We will continue to encourage them to take control of their lives, to take control of their health and to take control of their future.
We encourage people to get screened for TB. If infected with TB, people need to go on treatment as soon as possible and ensure that they complete their treatment.
This is essential if we are to save lives and curb the spread of the disease. We know that every person with untreated TB can infect up to 15 others in a year.
Ladies and Gentlemen,
Last year, in Klerksdorp, our country launched a massive TB screening campaign to detect and combat TB infections.
This campaign targets key vulnerable populations with a high degree of susceptibility to TB infections.
These include inmates in correctional services facilities, mineworkers, communities in mining areas, and children. Our mass TB screening campaign remains a central theme of South Africa’s commemoration of World TB Day this year.
It is appropriate that Lephalale has been identified as an important place to spread awareness about this screening campaign.
Lephalale is undergoing massive economic development, fast population growth and rapid urbanisation. This growth is being driven by the expanding mining and energy generation sectors.
While we are witnessing significant declines in TB infection across the country and in all provinces, TB infections in Lephalale are increasing, especially in emerging informal settlements such as Marapong.
In Lephalale, TB/HIV co-infection stands at about 65%, compared to the national average of 55%. We are here with our local and global partners because we are keen to prevent these public health challenges from worsening and to reverse them as rapidly as possible.
We are aware that we are more likely to succeed in Lephalale if we have strong partnerships with non-government entities, including the private sector.
In this regard, I am happy to announce a successful partnership we celebrated with the private sector earlier today.
People in Marapong have until now received health services from a four-roomed house that was converted into a clinic.
Each month, about 4,000 people seek health care from this facility. We are pleased that Exxaro, supported by Eskom, donated to the Limpopo Department of Health a building which was previously used as a private clinic.
I was honoured to open Marapong Community Health Centre earlier today.
The new clinic, much larger than the old clinic, now provides a full package of primary health care services to the community of Marapong.
Ladies and Gentlemen,
South Africa ranks among the 22 high burden countries that collectively contribute approximately 80% of the total global burden of all TB cases.
It is important that as a country we know the true burden of TB in South Africa so that we can deploy the appropriate level of resources required for an effective response.
Accurate data will enable us to better measure our performance as we respond to the epidemic.
To date, we have relied on estimates provided by the World Health Organization on South Africa's TB incidence and prevalence.
Although the numbers are informative, they are still estimates open to contestation.
The WHO has always urged countries to undertake a national TB prevalence survey at least once every 5 years.
I am happy therefore to launch today, South Africa's first National TB Prevalence Survey.
This crucial survey will be undertaken by the Department of Health supported by the South African Medical Research Council and the Human Sciences Research Council.
We expect the survey to be concluded within two years, and look forward to getting a truer indication of our TB burden.
Ladies and Gentlemen,
In the last year, since we launched ourmassive TB screening campaign, over 400,000 TB screenings were conducted on inmates in correctional facilities.
Nearly 5,000 of those tested were confirmed to have TB. Had we not implemented this programme, many of these inmates would not have been diagnosed and therefore not treated and cured.
Our mine inspectors have reported that 90% of the 246 controlled mines are providing TB services to their employees. More than 405,000 community members in six peri-mining communities were screened for TB in the last year.
Besides screening people in communities, we continue to actively screen patients who use public health facilities.About 30 million screenings for TB were conducted in South African health facilities in the past year.
We encourage those infected with this very contagious disease to bring those they had close contact with, especially family members and co-workers, to our clinics to be tested for TB.
As it enters its second phase this year, the TB screening campaign will focus on metros, which together account for about 40% of our TB burden.
We will encourage and support local authorities to eliminate TB hotspots in our cities. With support from the Global Fund and funding from the United States government, the Department of Health will deploy significant resources to metros to support TB interventions in informal settlements.
The massive TB Screening campaign will enter its third phase in 2017, with a focus on Eastern Cape, Gauteng, KwaZulu-Natal and Western Cape, which together carry about 75% of South Africa's TB burden.
Ladies and Gentlemen,
We continue to mobilise more resources for the TB response.
Government, with support from technical partners, conducted investment cases for TB and HIV which aimed to investigate exactly what we need to do to stop TB and HIV infections and mortality.
We analysed TB and HIV interventions together, as both have a large impact on new TB cases and deaths from TB. We found that we would not be able to reach these targets unless we scale up all available HIV and TB interventions.
This includes continuing with our active case finding campaign, doing better at screening people at the highest risk of TB, and diagnosing and treating 90% of all TB cases.
If we do this, we can reduce TB deaths by 35% by 2020 and by 95% by 2035. We can reduce incidence by 20% in 2020 and by 90% in 2035.
These interventions will therefore massively reduce both the burden of TB in South Africa and, in the long run, the amount of money spent on diagnosis and treatment. In short, these investment cases found that by achieving three key targets we can significantly reduce the burden of TB and HIV.
These are the 90-90-90 targets – which mean that we need to test at least 90% of those most vulnerable to these diseases; treat at least 90% of those found to have these diseases; and ensure that 90% of those with TB are cured and that at least 90% of those with HIV are virally suppressed.
This is a very important finding and I wish to congratulate all those that participated in this process.
Let me also take this opportunity to announce that the reports on the Investment Case are now available for download from the SANAC website – either the short summary or the full report.
On the basis of the investment case for TB, government has allocated a further R240 million to the fight against TB in the 2017/18 financial year, which will increase to R500 million in the 2018/19 financial year.
We are concluding grant negotiations with the Global Fund for a further R600 million to support the TB response for another three years, again based on the results of the Investment Case.
These resources will help sustain the TB interventions we started among key populations, including inmates, miners and people living in informal settlements.
Ladies and Gentlemen,
Let me conclude by reiterating the important messages that we need to get out to our people.
All South Africans can act to reduce the likelihood of TB infection.
Something as simple as covering our mouths when we cough can make a huge difference.
All South Africans should know the symptoms of TB. These include coughing for two weeks or more, persistent fever for more than two weeks, and inexplicable weight loss, drenching sweats and fatigue.
Anyone experiencing these symptoms should immediately visit a health facility for investigation.
Those who are initiated on treatment need to adhere to and complete their treatment – to ensure that they recover fully and that they don’t develop drug resistance.
On World TB Day this year, it will be exactly 134 years since the bacterium that causes tuberculosis was identified.
At the time, the disease was responsible for the death of one out of every seven people in Europe and the Americas. And yet, even after a century of remarkable scientific progress, TB is today a significant cause of death globally with an estimated 2,000 deaths from TB per day.
Africa bears the brunt of the disease with 9 of the 22 high burden countries in our region. While TB is an age-old disease, the world is still battling to eradicate it. But we know that we can.
We, the people of Africa, have the means to end TB in our lifetime.
We have a plan. We are mobilising the resources.
We have the determination and the will.
We will succeed.
I thank you.
