J van Wyk: World TB Day

24 March 2009

Programme director
Members of the Executive Council
Members of the Provincial Portfolio Committee on Health
Acting Executive Mayor of John Taole Gaetsewe District Municipality, Mr B
Gaobusiwe
Mayor of Moshaweng Local Municipality, Mr T Seikaneng
Mayors and councillors of district and local municipalities from John Taole
Gaetsewe district
Community and religious leaders
Government officials from various government departments
Representatives from the private sector
Distinguished guests
Ladies and gentlemen
Community of Tsineng and surrounding areas

Good morning to you all. I am honoured to be part of this important event
here today. The bacterium that causes tuberculosis was discovered on 24 March
1882 and that is why we are commemorating World TB Day every year on 24
March.

The fight against TB, HIV, AIDS and Sexual Transmitted Infection (STI)
cannot be the sole responsibility of one sector, department, ministry or
organisation. We want to use this event to mobilise the community and all
relevant stakeholders to work more closely with the Department of Health (DoH)
and the Northern Cape Provincial Government (NCPG) to deal with the challenge
of TB in the province. The fight against TB is the responsibility of us all. It
necessitates the involvement of all stakeholders to improve socio-economic
conditions by addressing poor living conditions, the high unemployment rate and
prevalence of HIV. Increased number of patients is contracting TB, the
emergence of extensively drug resistant (XDR) TB over the past two years has
further warranted strengthening of the TB program of government.

TB is a major cause of illness and death worldwide, especially in Asia and
Africa. South-Africa ranks fourth in the world with an incidence rate of 940
per 100 000 population. The Northern Cape province ranks third highest in the
country with a TB incidence rate of 998 per 100 000 population during 2007. A
gradual decrease in new TB cases is marked for the fourth quarter period of
2007 – 1 868 to the third quarter period of 2008 namely 1 751. This highlights
the need for a more intensified campaign for TB cases at community and facility
level. Furthermore, is a major dip marked vis-à-vis conversion rate from 604 to
405 during the first quarter of 2008. This can be attributed to the lack of
education amongst TB clients to honour follow-up dates as well as poor
community participation in promoting a health seeking culture.

The province experienced a downward trend in the cure rate yielding 767
cured cases for the fourth quarter of 2006 compared to 545 cured for the third
quarter of 2007. The defaulter rate increased significantly over the past four
quarters with 7,2% reported for the fourth quarter period of 2006 compared to
11,5% for the third quarter period of 2007. The European Union (EU) defaulter
tracer project was deployed as an intervention strategy, but still needs
strengthening. The number of patients who died whilst on TB treatment remains
high with 62 patients who died during 2006 and 53 in 2007. The threat of drug
resistant TB is still present with three MDR TB cases diagnosed for the fourth
quarter period of 2006 compared to 12 cases for 2007.

This information and statistics provided above is ironic in the sense that
the fact of the matter is that TB is curable. Despite the intensified education
and awareness campaign led by the Department of Health in the form of TB
Blitz's in the province, we still experience increased number of new TB cases
marking high transmission of TB in the community, a high percentage of
interruption and default form treatment in our rural communities. In a recent
report by Stats SA released, they reported that out of every 100 people who
die, 13 of them die from TB and they are in the employment age group. The cause
of this reality is as a result of amongst others:

* when people have TB symptoms they do not immediately go to the clinic to
test themselves
* many of our people still do not complete their TB treatment, which is
important if you want to be cured; and if you don't want to get more serious
forms of TB
* many people still live in places that are not clean and some do not undertake
simple steps such as opening of the windows at home in the morning to allow for
fresh air.

It is reported that some people do not want to take their medication. They
don't want to be cured because they want to benefit from the temporary
disability grant. However, what they forget is that they may also die as a
result of their behaviour. Some of them risk leaving behind their children and
families who still need them. When you don't take your treatment in the manner
that you should, the TB you have may also become serious.

TB in our province has reached a critical stage whereby we as a province
have to stand together to fight this disease. Importantly to mention is to
request our people not to discriminate against people with TB, because what
happened to them can also happen to you and me. It must also be kept in mind
that TB does not discriminate. Anyone can contract TB, irrespective of race,
colour, religion or gender. TB is a disease that attacks people with poor
immune systems such as the chronically ill and those living with HIV and AIDS.
This however does not mean that only people with HIV and AIDS can get TB.
Anyone can get TB, whether you are HIV positive or HIV negative, young or
old.

TB is not only a health problem, but also a social disease. Poor social
conditions our people are living in which includes poverty, overcrowded housing
where ventilation is poor and living conditions are cramped and general
stressful situations of everyday life are all contributing factors to the
spreading of the disease. Smoking is also an important contributing factor that
increases the chances of contracting TB.

In the process of taking responsibility of your health, you should get
tested for TB if you display any of the following symptoms – coughing for more
than two weeks, coughing up blood, no appetite, chest pains, weight loss, lumps
and swellings, tiredness or weakness of the whole body, sweating at night, even
when it is cold, getting fever which comes and goes and becoming short of
breath for no reason. If you are living with someone who has TB, it is
important and essential to get yourself tested at the nearest health care
facility to start treatment for at least six months. Important to remember is
treatment is free of charge. An urgent request is not to stop TB treatment
until a health care worker has indicated to you to do so. TB treatment has been
designed in such a way that is requires regularity, accuracy and endurance,
otherwise it will not work.

The large number of TB cases puts an enormous burden on the health system
and the economy of our country. It is therefore that I want to emphasise again
that we must all take hands to battle this disease, otherwise TB will become a
monster in our country that we will not be able to control.

The theme for this year's World TB Day: "Stop TB… Complete your treatment!"
This slogan is a message to all South-Africans to start playing their part in
the challenge to stop TB and motivate those affected by TB to complete their
treatment and become healthy citizens again. TB is a community problem. This is
because when many people in a community have TB, there is a strong chance that
other people will catch it. We must prevent TB and help those people who have
the disease.

We can work towards better living and working conditions:
* We need houses with enough space and fresh air
* We need to be able to get healthy foods which do not cost a lot of
money
* We need cleaner workplaces

We can help people who have TB by doing the following:
* be a Directly Observed Treatment (DOT) supporter
* help someone to take the TB medicines
* ask at the clinic how you can help
* respect people with TB just as we respect everyone else
* join organisations which help people with TB.

DOT supporters play a very important role in the fight against TB and their
role and contributions should not be underestimated and taken for granted. It
is these workers that support and check up on TB patients to ensure that they
receive the necessary as well as adequate treatment and that they are taking
their medication properly and on time.

Important is that all children should be immunised. TB can also be prevented
by giving children a Bacillus Calmette-Guerin (BCG) immunisation. This should
be given to all children when they are born. This stops them getting sick from
TB later in life. Take your child to the clinic to get a BCG if he or she was
born at home. The best way of stopping TB from spreading in the community is to
make sure that everyone who has TB is properly treated.

Government plays a very important role in the fight against TB. The
government is working very hard to stop TB from spreading. It has formed
partnerships with the media, organisations and workplaces. This is to make sure
that everyone knows about TB and that it is easy to cure.

Government nurses, doctors and health workers are trained to know about TB.
They know how to diagnose and treat people. The earlier you know you have TB,
the easier it is to treat. This is why government looks for people who might
easily get TB. This includes children who live with someone who has TB.

The government also helps these people by giving them preventative medicine
to stop them getting TB. The government helps people who have TB. The treatment
is of very high quality. You will not have to pay for it. The government uses
the DOT method to treat and cure TB. The government is trying to fight the
stigma and discrimination around TB. They make sure that TB patients can go for
counselling and get support.

People who have TB has to make sure that their rights are upheld and it is
the duty of their families to also familiarise themselves with these rights to
ensure correct and fair treatment of their family members. These rights
are:
* you have the right to privacy and confidentiality – nobody else needs to know
about your illness if you do not want them to know
* you have the right to be treated with respect
* you have the right to know what is being done to you at the clinic
* you have the right to sick leave if you have TB
* you have the right to information about your treatment.

Furthermore, government launched in 2007 the National TB Strategic Plan
which sets out in detail what government is planning to do to further
strengthen the TB control programme. The plan also addresses issues related to
healthy lifestyles, infection control, community participation and
intersectoral co-operation. The Northern Cape Province launched the Provincial
TB Crisis Management Plan in 2006 and held extensive TB Blitzes' in each of the
five districts in an attempt to halt the spread of the disease.

The contributions of our partners in the fight against TB cannot be over
emphasised namely Khomanani, TB free, pharmaceutical companies, the farming
sector, religious sector, municipalities, the Department of Correctional
Services (DCS), the South-African Defence Force (SANDF), community structures,
non-governmental organisations (NGOs) and community based organisations (CBOs).
TB free, a strategic partner of the Department of Health (DoH), has been
specifically established in the fight against TB. TB free is both the vision
and the name of a joint initiative and project being undertaken by the Nelson
Mandela Aventis Project for combating TB to improve the health situation of
people with tuberculosis in South Africa. The goal of the organisation is to
increase tuberculosis awareness and compliance with the tuberculosis treatment
regime by establishing TB free centres and training DOT (Directly Observed
Therapy) supporters throughout South Africa.

The objective of TB free is to increase TB case detection rates and patient
cure rates especially in those areas of the country most affected by this
highly contagious yet curable disease. TB free supports and is aligned with the
South Africa National Tuberculosis Control programme and the World Health
Organisation (WHO) targets of a 70 percent case detection rate, an 85 percent
cure rate and a treatment interruption rate of less than five percent.

The John Taelo Geatsewe District, together with the Siyanda district, has
maintained the highest TB cure rate above 60 percent. Problems are still being
experienced with case finding in the Moshaweng Municipality and as such more
effort needs to be placed on raising awareness.

When we speak about TB it is important that we also speak about HIV and
AIDS. We know that there is a close link between HIV and TB. This does not mean
that every person who has TB is HIV positive. But if you are HIV positive you
are very likely to have TB. However even in this case TB can be cured, it only
means that you must take your medication.

As government we will keep on telling our people that you must abstain
especially young people. Let's focus on our education instead, they say the
best things in life come to those who wait and work for them. It is important
that those who are in relationships remain faithful in those relationships.
Information available indicates that HIV infection is growing amongst the older
and the middle age generation. This is the economically active generation that
is in stable relationships and in the working age. As communities, we therefore
need to change our behaviour. We need to re-establish moral values and a strong
sense of responsibility in ourselves ad adults as well as our children.

In conclusion, I would like to call upon all people of Tsineng and the whole
of South Africa, to join the government and all related stakeholders, to help
stop TB. It is our responsibility as citizens, to contribute our efforts and
energy in the creation of a South Africa that is free from TB. Let us support
and motivate those fellow citizens: "Stop TB, complete your treatment!

I thank you.

Issued by: Department of Health, Free State Provincial Government
24 March 2009