SA comes under fire for failing to stem XDR-TB
South Africa’s health department has come under fire from activists and HIV/tuberculosis experts for its failure to respond to extensively drug resistant (XDR) TB with claims that one of the critical drugs to stem this epidemic is not available in KwaZulu-Natal, the hotbed of the outbreak.
The criticism has come in the run-up to the 38th Union World Conference on Lung Health starting in Cape Town next week.
‘Almost nothing has happened,’ said Dr Nesri Padayatchi, Site Manager of the Centre for the AIDS Program of Research in South Africa (CAPRISA) and former head of King George Hospital where KwaZulu-Natal’s multi-drug resistant (MDR) and XDR TB patients are treated.
Padayatchi said that despite being alerted to the XDR strain as far back as 1995 and again in May 2005, the response from the provincial and national health department was ‘nothing’.
She said that since the global spotlight turned to Tugela Ferry, where the XDR outbreak was first reported, the national health minister called a World Health Organisation meeting and committed to a seven point plan.
‘To date, three points have been addressed, and only in Tugela Ferry. Because of the media and civil society attention more money and staff has been sent to Tugela Ferry. But what about the rest of the country? Almost nothing has happened and we really have not made any progress,’ said Padayatchi.
She said a visit to King George Hospital had confirmed that more beds had been made available, but that staff had informed her that PAS, one of two drugs used to treat XDR, was no longer available from the supplier.
This year, 2 500 MDR cases have been diagnosed in the province while only 600 of these have been treated at King George.
‘The national community may be concerned, but the national health department has done very little to address what is a global problem,’ said Padayatchi.
Stephen Lewis, former United Nations Special Envoy for HIV/AIDS in Africa and currently co-director of AIDS-Free World said the MDR and XDR epidemics spoke of ‘extraordinary negligence’.
‘It’s a global health scandal of monumental proportions,’ said Lewis.
Figures released during the teleconference revealed that each year, nearly two million people die of TB, a curable disease.
Failure to properly address TB has led to deadly, drug-resistant strains.
‘Despite global commitment to treat 1.6 million people with drug-resistant TB by 2015, little progress has been made,’ said a statement from the Open Society Institute’s Public Health Programme.
Today, of the more than 420 000 new cases of drug-resistant TB annually, only 2 percent are receiving treatment.
Drug-resistant TB is more complicated and expensive to diagnose and treat, especially for HIV-positive people.
South Africa is grappling with ways in which to treat the growing and slowly overwhelming number of MDR TB patients.
On Tuesday, a patient was shot and wounded and a security guard stabbed at the Sizwe Tropical Disease hospital in Edenvale, east of Johannesburg, after a protest by TB patients turned violent.
Newspaper reports said the drama started when about 50 MDR TB patients blocked the hospital’s entrance, demanding better treatment and an end to what they called prison-like conditions.
Patients said they were being treated like prisoners while their families were only informed of their condition once they had died.
Brooklyn Hospital, the main treatment centre for MDR-TB treatment in the Western Cape, is bursting at the seams, with patients forced to wait weeks for a bed.
Dr Paul Farmer, Founding Director of Partners In Health, shared ‘the cheerful part of the story’.
He revealed that community based interventions introduced in Peru 12 years ago had led to 10 000 MDR TB patients accessing effective treatment.
Farmer is currently assisting with the introduction of a similar intervention in Lesotho whereby community health workers assist MDR patients at home and address issues such as adherence and infection control.
‘We need to get our act together before turning to the global community,’ said Padayatchi. ‘There are a lot of simple things we can do right away.’ ‘ Health-e News Service