Ministers of Health on Extreme Drug Resistant Tuberculosis (XDR TB)
22 September 2006
A meeting of SADC Ministers of Health, chaired by the Minister of Health of
Lesotho Dr Phooko, was convened in the morning of 22 September 2006 during the
Second Session of the African Union (AU) Ministers of Health in Mozambique,
Maputo.
The objective of the meeting was to discuss the status of XDR TB in the
region. XDR TB is multi-drug resistance TB that does not respond to at least
three of the second-line TB treatment drugs.
Globally, this strain has also been reported in several other countries
including the United States of America (USA) and Latvia, which have four
percent and 19 percent prevalence rates respectively.
At the SADC Ministers of Health meeting, the Minister of Health of South
Africa Dr Manto Tshabalala-Msimang shared the South African experience and
challenges in addressing XDR TB.
Cases of XDR TB were found in a hospital in the province of KwaZulu-Natal in
South Africa. Subsequently, there have been reports of a small number of
additional cases in Gauteng and Free State provinces.
This could mean that there are other XDR TB cases in the country and in the
region as these reported cases were identified by special interventions.
The outstanding challenges are as follows:
* In the past 30 years, no new TB drugs and diagnostic tests were develop, thus
making XDR TB much more difficult to treat because of the limitations of
drugs.
* The strain is resistant to the first line of TB drugs and in addition to
these drugs, it is also resistant to at least three of the second-line TB
drugs.
* Effective treatment of TB requires more than two drugs which then mean we
have to bring back the drugs that were taken off shelves due to their side
effects and toxicity.
Ministers agreed that there is multi-drug-resistant (MDR) TB in our region
and noted the few new developments of the XDR TB strain.
Ministers agreed that this is a challenge that would need a regional
approach, taking into consideration the free movement of people within the
region and continent.
The Ministers also agreed that the magnitude of the problem in the region
needed to be determined.
Proposed way forward:
* to strengthen the normal TB programme within countries and the region to deal
with the resistance
* to enhance surveillance systems
* to strengthen infection control
* to strengthen diagnostics techniques for TB and share expertise
* to encourage the pharmaceutical industry to develop new drugs and diagnostics
techniques for effective TB treatment and rapid diagnostics
* to develop a preparedness plan on XDR TB within Member States and at regional
level to deal with the challenge
* mandated the TB experts and programme managers to meet as a matter of urgency
before the end of the year
* to mandate SADC officials to attend the forthcoming XDR TB meeting scheduled
between World Health Organisation (WHO) and the South Africa Minister and to be
held as soon as possible
* to mandate SADC Secretariat based in Botswana to co-ordinate information
sharing within the region.
In conclusion, a SADC regional approach to the management of XDR TB must be
effected and regional co-operation and sharing of information between countries
must also continue.
Contact:
Lebo Lebese
SADC Spokesperson
Cell: 082 467 8496
Charity Bhengu
Department of Health Media Liaison Officer
Cell: 082 679 7424
Issued by: Department of Health on behalf of SADC
22 September 2006
