“We have conducted TB surveys in health facilities, we wanted to check whether the preventions of TB is effective in different areas, so our finding in local facilities we have found that most of the facilities are very poor when it comes to TB prevention,” said Daniel Mathebula, who is the provincial trainer for TAC in Limpopo.

TB is an airborne illness and adequate prevention includes having well ventilated spaces and the use of ultraviolet lights that can kill the bacteria. High risk groups such as people with uncontrolled HIV and children under five living with someone with TB are also supposed to be offered a course of medicine to prevent TB.

TB is an infectious disease that is a major cause of ill health, one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent (ranking above HIV), according to World Health Organisation.

TAC called on the provincial health department to implement evidence-based strategies to combat the disease.

The organisation will be hosting an accountability meeting with province’s TB coordinator later this month following a series of similar meetings with district TB coordinators in Vhembe and Mopani districts.

According to TAC, these meetings have revealed that the fight against TB in the province leaves much to be desired and requires renewed and sustained attention.

TB fight suffered under COVID-19

COVID-19 has negatively affected the TB fight not only in Limpopo but across the country.

Earlier this month Health Minister Zweli Mkhize noted in his budget vote speech that there has been “a 50% reduction in the number of TB tests conducted during the COVID-19 period” with “a suboptimal TB success rate of 78,3%, against a target of 90%”.

Mathebula said that while COVID-19 may have played a role in the decline of TB services in the province, access to proper care, including prevention efforts, is a human rights issue.

“The provincial health department might have several reasons of not having the proper prevention methods in health facilities, it might happen that because of COVID-19, TB was not considered well. Again what we want is that TB should be considered as a human rights issue, so we want to see department considering TB treatment and prevention like they do in HIV,” he said.

Access to new treatment

“As part of the district accountability meetings in Vhembe and Mopani, we wanted to check whether the department is distributing  bedaquiline to patients,” said Mathebula.

Bedaquiline is a newer anti-TB drug which greatly improves the success rate for the treatment of hard-to-treat multi-drug resistant TB (MDR-TB).

Mathebula said TAC found that bedaquiline was available in public hospitals in the province but could not confirm that the drug was also widely available at clinics.

“So we thought is better for us to invite the provincial coordinator for TB to come and answer some of the questions which were not properly answered by district coordinators,” said Mathebula.

The demands which TAC would be submitting to the provincial TB coordinator on 28 May range from distribution of bedaquiline in all local clinics in the province to the implementation of sound TB prevention strategies and improved patients tracing methods.

“So that’s is why on the 28^th of this month we would be having provincial accountability meeting and we would submitting the challenges that we have found in the different facilities during our TB surveys,” said Mathebula.

Improving TB prevention and treatment

“We would be asking the provincial coordinator about the availability of bedaquiline in local facilities like the clinics because MDR-TB patients access treatment there. We found that there is poor TB prevention in different health facilities and we want to know whether the department is planning to do something to improve prevention,” he said.

Mathebula added that TB testing needed to be ramped up in the province as well as active tracing of people known to have been exposed to TB because they live or work with individuals diagnosed with the disease. Additionally, patients on treatment should be followed up to check if they have defaulted on their medication and are continuing to spread TB in their communities.

“With regards to the issue of tracing, we want to check whether there are proper tracing methods in different communities, because we do have defaulters and we think they should be traced back to care,” he said.

Limpopo Department of Health’s spokesperson Neil Shikwabani failed to respond to repeated requests for comment. – Health-e News