Speech by the Gauteng MEC for Health, Mr AHM Papo, MPL, on the occasion of 2014 World TB Day
Member of the Mayoral Committee for Health in the City of Tshwane, Clr Eulanda Mabusela,
Local Councillors present,
Representatives of TB Free,
Care givers and NGOs present,
Ladies and gentlemen.
When the African National Congress (ANC) took over the reins of government in 1994, there were fourteen Departments of Health in the country. The health system was fragmented, and it was not responsive to the real health needs of the majority of the citizens of our country.
Decades of deliberate impoverishment exacerbated the burden of TB among poor communities, and there was no coordinated response to the scourge of TB. Since 1994, the ANC government prioritised reducing the burden of TB by also addressing other social determinants which contribute to its burden. That is why we declared it a national priority in 1996.
While we have not yet won the battle against TB, we are making strides in early diagnosis, early treatment and follow up on those who are on treatment.
To demonstrate our commitment to reduce the burden of TB in Gauteng we allocated a budget of R225 089, 000 to fight this scourge in the 2013/14 financial year. This figure does not take into account expenditure by hospitals in diagnosis, hospitalization and treatment of TB patients.
We acknowledge that our province is faced with the challenge of in-migration and migration from neighbouring countries, we still have a responsibility to ensure that those patients who continue to reside in our province while on treatment, are indeed followed up so that they do not default.
Since 2009 we have made progress in improving the TB Cure Rate from 78, 95% to 83, and 5% by the end of the third quarter of 2013/14. The percentage of TB patients who do not complete their treatment improved from 5,9% in 2009 to 4,9% in 2013.
We have purchased and installed 15 Gene-Xpert machines at the following hospitals; Steve Biko, Dr George Mukhari, Chris Hani Baragwanath, Charlotte Maxeke, Helen Joseph, Tambo Memorial, Kopanong, Tembisa, Natalspruit, Dr Yusuf Dadoo, Pholosong, Bertha Gxowa, Sebokeng, Carletonvile, Edenvale and Jubilee hospitals.
These machines speed up diagnosis of TB and Multi –Drug Resistant TB. I therefore need to caution regarding interpretation of the apparent increase in the number of people who are diagnosed with Multi-Drug Resistant TB. Availability of these Gen-expert machines has resulted in quicker detection of Multi-Drug Resistant TB.
We have thus been able to save lives of people whose conditions would have worsened, and at worst infected others while awaiting diagnosis. I have given instructions to CEOs and Clinical Managers to formally inform relevant districts whenever each and every case of Multi-Drug TB is diagnosed at the hospitals which have Gene-expert machines. If these patients are not followed up by districts, having these Gene-expert machines serves no useful purpose.
I have also given an instruction that each of the fifteen hospitals I mentioned above must provide statistics central so that appropriate support and monitoring can be provided.
Program Director,
We commit ourselves to work hard to reduce the burden of TB. Our province covers just over 17 000sq km - approximately 1.4% of the total and surface of South Africa. It is the smallest province in terms of size, but the densely populated of all the nine provinces. 97% of the province is also urban. The Ward-Based Outreach Teams must therefore intensify efforts to trace treatment defaulters.
Despite its size, Gauteng is home to just over 11 million people. This dense population is evident in over-crowding and increase in living conditions that are not conducive to a healthy population. Such living conditions are some of the factors which contribute to the increased rate of TB infection in our province. Patterns of migration are also a compounding factor.
However, some countries with smaller economies and even smaller Health Budgets that Gauteng have better TB outcome indicators. In order to break the back of TB we need to heighten public awareness on the dangers of TB, and its infectiousness.
We must continue to educating our people on the signs and symptoms of TB. We must emphasise the importance of completing the TB treatment and make patients aware of the consequences of failure to do so. Drugs alone will not win us the war we are faced with. We have to re-consider the tactics that we have employed in the past in the fight against TB.
We need to strengthen community awareness because there is evidence that our people are not presenting themselves to be tested for TB earlier when they begin to show symptoms.
The fact that some of our people only come for treatment when their condition has worsened means that the burden of TB will continue increasing. As I stated earlier, the over all TB Cure Rate in the province is improving, however, we need to focus on sub-districts.
The District Clinical Specialist Teams have a very important role to play in this regard. Identification of areas where there are high rates of infection in any sub-district should raise alarm bells to District Clinical Specialist Teams.
Conversely those sub-districts, which report improvement in TB Cure Rates and reduced Defaulter Rates, should share their experiences with the rest of their respective districts. I am saying this being mindful of the fact that Region 2 Sub-District (which comprises of Saulsville) has registered notable improvement within a year.
In the same period in the 2012/13 financial year the Cure Rate stood at 83%; as web speak it stands at 84%. We therefore need to applaud all health workers and caregivers who have contributed to this improvement.
As the ANC government we will continue to improve the health status of our people. We will continue to work together with all sectors of society to spread the message that: TB is curable! In the new financial year we will intensify our efforts to access those areas which are hard to reach in order to trace treatment defaulters.
We plead with families of those who are on TB treatment to provide support and encourage them to adhere to treatments. In this way we will break the back of TB.
