TB is a ‘€˜human disgrace’€™

Speaking at the SA Tuberculosis Vaccine Initiative symposium in Cape Town, Dr. Marcos Espinal, Executive Secretary of the Stop TB Partnership, described TB as a ‘€œhuman disgrace’€ that has been in place for thousands of years.

Espinal said that although the MDG pertaining to TB would be met globally, Africa and part of East Europe would miss out.

‘€œAfrica is not doing well in terms of targets,’€ he said, adding that incidence had declined across the world,   but that it needed to decline by between five and six percent and not the current one percent.

Espinal said many countries were not adopting the Global TB Plan and that prevalence and mortality were not declining fast enough.

Of the 41 priority countries identified worldwide, almost a third of TB patients should have been tested for HIV by 2006. But only 11 percent have been tested so far.

Research was also showing that with every 10 percent increase in TB, a county’€™s economic growth fell between 0,2 and 0,4 percent. This has led to the World Bank pronouncing that the benefits of TB control   were worth 10 times the investment.

Espinal said a survey of 134 countries where TB incidence had fallen quickly, showed that these countries also scored well on the Human Development Index and in terms of child mortality and sanitation.

South Africa has the seventh highest TB incidence globally, said Dr Krish Vallabhjee, head of TB hospitals in the Western Cape.

Vallabhjee, who gave an overview of South Africa’€™s TB epidemic said the Western Cape had the second highest incidence in South Africa at 1030 per 100 000. KwaZulu-Natal is the highest, with an incidence rate of 1075 per 100 000.

In South Africa, the TB incidence had increased massively over the last 10 years from 269 per 100 000 people to 720 per 100 000 people. There is acceptance that South Africa’€™s epidemic is mainly driven by the HIV epidemic with people co-infected standing at 55 percent. Statistics South Africa figures show that TB is the leading natural cause of death in South Africa.

Vallabhjee revealed that the Western Cape had accounted for 35 percent of all multi-drug resistant TB in 2004, but that this had fallen to 19 percent in 2006. In KwaZulu-Natal the figure was 9 percent in 2004, rising to 41 percent in 2006.

In the Western Cape 73 extensively drug resistant (XDR) TB cases were identified last year with 26 of these people dying.

Vallabhjee said it was a challenge to recruit health workers to work in TB hospitals. ‘€œThere is a lot of anxiety,’€ he said. A recent drive to recruit doctors and nurses to the province’€™s six TB hospitals drew only one application from a professional nurse and two from doctors.

Espinal concluded that he was convinced that there was better future for TB and that it was ‘€œonly a matter of time’€ as new drugs, diagnostics and vaccines are a few years away. More information on the MDGs can be found here. ‘€“ Health-e News Service.



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