TB crisis plan targets four districts
Health Minister Dr Manto Tshabalala-Msimang admitted that South Africa is doing ‘very, very badly’ at curing tuberculosis at the launch of a TB crisis plan on World TB Day yesterday (24 March),.
Only about half the country’s TB patients are cured, while almost 7% of patients who are not cured go on to develop multi-drug resistant TB, which is hard and expensive to cure.
The crisis plan will focus initially on four health districts with both poor TB cure rates and many TB patients, namely eThekwini metro (Durban), Johannesburg, the Nelson Mandela metro (Port Elizabeth) and Amatola district (East London).
The plan was launched at King George V Hospital in eThekwini, the worst performing metro in the country with over 24 000 new TB patients in 2004, and a cure rate of less than one in three.
‘The critical elements of the plan include adequate human and financial resources to fight TB, access to laboratory services, better TB reporting, recording and referral of patients and a highly visible social mobilisation and media campaign,’ said Tshabalala-Msimang.
‘Everyone needs to know the symptoms of TB: coughing for more than two weeks, night sweats, loss of weight and general tiredness,’ she stressed.
The Minister played down the link between TB and HIV, despite consensus among medical experts that HIV is driving the TB epidemic.
While the crisis plan includes ‘scaling up joint HIV and TB measures’, Tshabalala-Msimang said that making the link between the two epidemics could mean that patients were ‘double stigmatised’.
‘If you come to us with TB symptoms, you have the right to be treated as a TB patient. If we see that we are not succeeding, only then will we investigate HIV,’ said Tshabalala-Msimang.
She highlighted multi-drug resistant TB as a ‘real and serious problem’, saying that while it cost government between R400 and R600 to treat a TB patient for six months, it cost R24 000 to treat someone with MDR TB.
‘Imagine if we also have to put these MDR TB patients on ARVs. It will double the problem for us,’ aid Tshabalala-Msimang.
Doctors from King George Hospital, which has one of the biggest MDR TB case loads in the country, said there was little information about how the MDR TB drugs interacted with antiretroviral drugs.
However, Dr VS Challa, a doctor with 30 years’ experience with TB, said TB and HIV had to be addressed together, as the twin epidemics could ‘wipe out the country’.
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