Deputy President Cyril Ramaphosa: World TB Day

Minister of Health, Dr Aaron Motsoaledi,
Ministers, Deputy Ministers and other government representatives,
Mr Phillipe Meunier and Dr Maxim Berdnikov of the Global Fund,
Members of SANAC,
Representatives of the Country Coordinating Mechanism,
Civil society partners and representatives of labour,
Ladies and gentlemen,

Dumelang! Lotshani! Avuxeni! Sanibonani! Ndaa!

Today our country marks World TB Day by launching the largest tuberculosis screening campaign yet seen in South Africa.

We do so because South Africa carries the greatest burden of TB in the world.

We do so because reducing the incidence of TB will substantially strengthen our fight against HIV and will contribute to building a healthier nation.

Everyone should know if they have TB.

Everyone should know what symptoms to look for and how to get screened for TB.

Tuberculosis remains a global threat.

Anyone can contract it.

Yet, it can be prevented and it can be cured.

As we commemorate World TB Day, we must resolve to end ignorance, stop the spread of TB and prevent the avoidable loss of life.

We are here in Klerksdorp because it is in a part of the country that is among those hardest hit by tuberculosis.

With its history as a gold mining town, Klerksdorp joins many other towns where the risk of contracting TB is high.

This community is also at the heart of a remarkable, inspiring story of hope which shows that tuberculosis can be beaten.

Klerksdorp was the birth place of Archbishop Emeritus Desmond Tutu.

As a child, this renowned anti-apartheid activist and Nobel peace laureate almost died from tuberculosis.

He contracted polio in infancy and tuberculosis at the age of twelve.

He survived tuberculosis with the help of a community of Anglican monks who provided him with hospital care for many months.

Tutu’s very presence in our midst reminds us that, through our collective will and actions, we can recover from TB.

It reminds us that we must all care for the wellbeing and health of our children and neighbours.

Those with TB must travel the road to recovery accompanied not only by government, the donor community and health workers, but by friends, families and communities.

Today, as we summon the nation to support and participate in this ground-breaking TB testing campaign, we must remind one another that to have tuberculosis is not a shame.

We must stand firm against prejudice, stigma and exclusion.

As Tutu himself said:

“When someone is ill, that is already a very heavy burden to bear – if in addition to the trauma and pain and all the emotional strain of being separated from your family and your loved ones, you also have the additional burden of people wanting you to be ostracised, of making out that this is a disease that decent people shouldn’t have.”

Sechaba, a re tlogeleng go seba ka batho ba na leng TB.

It is simply wrong!

Ladies and gentlemen,

The formal launch of our screening campaign is a response to South Africa's high TB burden.

Our incidence is the highest among the 22 countries currently responsible for 80% of the world's total TB burden.

The Statistician-General reported in 2014 that TB remained the number one killer of South Africans.

We are part of a global campaign to focus national responses on key populations and vulnerable groups with an elevated risk of TB infection.

In South Africa, these include inmates in correctional services facilities, mineworkers, communities in mining areas and children, especially those under 5 years.

We have identified six priority districts for the screening campaign:

• Lejweleputswa in the Free State,
• West Rand in Gauteng,
• Sekhukhune and Waterberg in Limpopo
• Bojanala and Dr Kenneth Kaunda in North West.

In the first year of this three year campaign, we aim to screen at least 135,000 inmates in correctional facilities and up to half a million mineworkers.

In these six districts, we aim to screen around 5 million community members and 1.2 million children in schools, early childhood development centres and crèches

We have already screened 59,000 inmates. This is a third of all sentenced offenders and awaiting-trial detainees.

The programme is on track to screen more than 90% by March 2017.

The programme has also already screened 140,000 community members in the six districts.

Nine inspectors have been appointed to assist the Department of Health to oversee the provision of TB services by the mines.

In the second year of the screening campaign, there will be an additional focus on the metropolitan councils.

In the third year, we will add the provinces of the Eastern Cape, Gauteng, KwaZulu Natal and the Western Cape.

Ladies and gentlemen,

It is important that TB patients on treatment adhere to and complete their treatment as prescribed by health workers.

We will institute a system to trace patients lost to treatment, and also contacts of known TB patients, including children and family members of inmates and mineworkers infected with the disease.

The poor socio-economic conditions that prevail in communities, especially poor housing and food insufficiency, provide a breeding ground for diseases such as TB, with children being particularly vulnerable.

Early childhood development can help to reduce infection among children and facilitate more effective detection.

Unfortunately, good quality early childhood centre and crèches are scarce in many communities, with some operating from shack structures.

We are therefore delighted that Aspen has undertaken to sponsor the building of a new early childhood development centre here in Kanana.

We are grateful also to AngloGold Ashanti for sponsoring a maternity and child care ward at Botshabelo Community Health Centre in Khuma.

These projects underscore the need for the private sector to play a prominent role in tackling this disease and supporting public health and development initiatives.

We look in particular to mining companies, whose assistance is critical in responding decisively to TB.

With these interventions, we aim to achieve the World Health Organization’s 2025 annual targets by reducing TB incidence to less than 150,000 infections, compared to more than 400,000 currently.

We aim to reduce TB deaths to less than 20,000, compared to more than 120,000 currently.

Prospects for success are high.

We have the support not only of our social partners here in South Africa, but also internationally.

In October 2013, the Global Fund to Fight AIDS, Tuberculosis and Malaria approved a substantial grant for our country valued at more than R500 million to be used in strengthening our response to the TB epidemic.

The grant has enabled us to acquire additional resources to step up our efforts among some of key populations we have identified.

The focus of our campaign is not limited to screening and treating TB.

We are focused also on reducing infection.

All South Africans can act to reduce the likelihood of 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,
• Inexplicable weight loss, drenching sweats and fatigue in children.

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.

This is to ensure that they recover fully and that they don’t develop drug resistance.

To address this major challenge – of drug resistance – we have strengthened our interventions aimed at improving diagnosis and  treatment outcomes of drug resistant TB.

We have the largest deployment of the latest machine to diagnose drug resistant TB – called GeneXpert. All the National Health Laboratory Service laboratories in the country have this machine and as a result South Africa conducts half the global volume of this test.

We are thus able to diagnose more drug resistant TB early. 

We have used government resources and those provided by the Global Fund to further decentralise the treatment of drug resistant TB.

More than 200 nurses have been trained to initiate patients on drug resistant TB medication and we currently have 298 decentralised sites in the country.

Bringing services closer to our communities is more convenient to our patients and results in better treatment outcomes.

In addition, we have started to treat drug resistant patients with the latest drugs approved for the treatment of drug resistant TB.

Speaking at the International AIDS Conference in Bangkok in 2004, former President Nelson Mandela said we cannot win the battle against HIV and AIDS if we do not also fight TB.

He said:

“TB is too often a death sentence for people with AIDS. It does not have to be this way. We have known how to cure TB for more than 50 years. What we have lacked is the will and the resources to quickly diagnose people with TB and get them the treatment they need.”

In South Africa today, we have the will to overcome TB.

Thanks to the Global Fund, government and others, we have the resources.

The challenge to all of us is to now go out and implement this campaign.

As I conclude, I wish to thank the Minister and Department of Health, the NGOs that have been contracted to implement the programme, the Department of Correctional Services, the SANAC Secretariat and the Country Coordinating Mechanism, and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

We have made great strides in our efforts to overcome HIV and AIDS.

We have mobilised millions of South Africans to test regularly for HIV.

We have initiated nearly 3 million people on anti-retroviral treatment.

Now is the time to do the same to stop TB.

Now is the time to be screened for tuberculosis.

Now is the time to know.

Ke a leboga. I thank you.

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