8 November 2007
The Department of Health welcomes the hosting of the 38th Union World
Conference on Lung Health in our country. We believe that this is an important
conference that will once again highlight the need to intensify interventions
against various lung diseases affecting our nation and the world.
We expect that there will be fruitful discussions about the important role
of tobacco control in the prevention of lung diseases. We believe that we have
played our role as a country in the development and adoption of the Framework
Convention on Tobacco Control which we have since ratified. As you may know,
South African government has been widely acknowledged as a leader in the effort
to stop the use of tobacco products.
On the tuberculosis (TB) front, we are pleased to announce that we have made
significant progress in the development of the new Tuberculosis National
Strategic Plan for 2007/11. The document we are presenting to you today is an
outcome of extensive consultation with local and international stakeholders in
the area of TB as well as HIV and AIDS.
The Plan is aimed at strengthening South Africa's response to the challenges
of TB as well as Multi-Drug Resistant (MDR-TB) and Extensive Drug Resistant
tuberculosis (XDR-TB). The Plan directs that routine culture and first line
drug sensitivity testing be done for all high risk groups such as re-treatment
TB patients, new TB patients who remain sputum smear-positive after two months
and symptomatic close contacts of confirmed MDR-TB patients. Second line drug
sensitivity testing will be conducted on all confirmed MDR-TB patients.
All confirmed XDR-TB patients are referred to an MDR-TB Unit for
hospitalisation for a period of at least six months and thereafter discharged
for ambulatory care at the nearest health facility with ongoing treatment and
psychosocial support provided. This will require strengthening of community
based care and follow up systems at community level. Enforced hospitalisation
or quarantine of patients with XDR-TB is only justifiable as a last resort
within a human rights framework after all reasonable voluntary measures to
isolate the patient have failed.
Monthly reviews and monitoring of patients are being conducted at the MDR-TB
Units until completion of treatment at the end of 24 months. Infection control
in all the TB, general hospitals and primary health care facilities is being
strengthened.
The new TB Plan also acknowledges the close connection between TB and HIV
and AIDS in our country and provides for interventions to deal with the
challenges posed by co-infection.
The Plan requires that all TB patients be offered voluntary HIV counselling
and testing. Those who test HIV positive will be offered cotrimoxazole
routinely. Ongoing psychosocial support and early diagnosis and treatment of
other opportunistic infections will also be provided and anti-retroviral
treatment (ART) should be made available to all TB patients who are
eligible.
The Plan also directs that a package of care for HIV positive patients
should include routine screening for TB, treatment for those with TB and TB
preventive therapy for those found not to have TB.
While the number of TB cases remains high, there is steady improvement in
successful treatment completion rates and in the cure rates. Both the cure
rates and successful treatment completion rates improved from 50 and 60 percent
respectively in 2001 to 57,6 percent and 70,8 percent respectively in 2006.
During the same five year period, the death rate has been fairly constant at
between six to seven percent and so was the treatment failure rate around 1,5
percent. There have been steady declines in the transferred out and not
evaluated rates.
Progress has also been witnessed in the four districts that were identified
as high focus areas because of high caseload and low cure rates. These
districts are: Amatole District and Nelson Mandela Metro in Eastern Cape,
Ethekwini Metro and City of Johannesburg.
The new TB Plan sets clear targets and indicators that are guided by
international targets. Over the next five years, we will improve our case
detection rate to 70 percent, cure rate to 85 percent and treatment success
rate to more than 85 percent.
The budgeting for this Plan has been done using the World Health
Organisation's Planning and Budgeting tool and covers the five-year period and
much of the funding will be from the provincial equitable share health
allocation.
To illustrate that government is serious about curbing the TB epidemic, we
have made available to provinces a total of R400m in this year's adjustment
budget to deal with MDR and XDR-TB. In the national department's budget bid for
2008/09, we have requested for additional funding from National Treasury to
assist in the fight against TB.
The development of this Plan and allocation of additional resources for its
implementation demonstrates the commitment of the Department of Health to
respond adequately to the challenge of TB. There is, however, a need for new TB
diagnostics and drugs to bolster the ability of all affected nations to succeed
in controlling TB. We hope that this conference will discuss and take a firm
stand in the dire weakness in the world's response to TB.
Clearly government has an important role to play in the fight against TB.
However, communities, the private sector, development partners also have
critical and complementary roles to play. Without a comprehensive response that
includes all of us, we cannot succeed in the fight against TB. We therefore
call on all partners to work together to ensure that the number of people that
contract TB is significantly decreased within the next five years.
Enquiries:
Sibani Mngadi
Media Liaison Officer
Ministry of Health
Tel: 012 312 0763
Fax: 012 325 5526
Cell: 082 772 0161
Issued by: Department of Health
8 November 2007
Source: Department of Health (http://www.health.gov.za)
