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TB plan has a gap between talk and action
PlusNews
2008-07-04
TB is South Africa's leading natural cause of death. Health Minister Manto Tshabalala-Msimang opened South Africa's first national tuberculosis (TB) conference this week with some welcome good news: her department is to acquire technology that will reduce the time it takes to diagnose drug-resistant TB from as long as four months to less than a week.
South Africa
is struggling with a rising incidence of multidrug-resistant (MDR) TB, a form
of the disease that does not respond to standard treatment with first-line
drugs. The difficulty of diagnosing MDR-TB using the current method of growing
cultures in a specially equipped laboratory has meant that many patients infect
countless others or die before their results are known. Although 7,369 cases of
MDR-TB were diagnosed in 2007, according to health department figures, it is
likely that many more cases went undetected. The new diagnostic test, which uses
a molecular method known as "line probe assays", was developed by the
World Health Organisation (WHO) and the Foundation for Innovative New
Diagnostics and tested in a South African field trial conducted by the Medical
Research Council and the National Health Laboratory Services. According to a WHO
statement, the trial produced results encouraging enough for the DNA-based tests
to be rolled out in 16 countries with a high TB burden, but delivery of the new
equipment and training staff in how to use it would take place over the next
four years.
Lesotho
is so far the only country equipped to do the tests.
Tshabalala's speech skimmed over the grim figures behind South Africa's TB
burden, among the highest in the world, and focused on the small gains made in
the last two years: a one percent drop in national TB infections between 2006
and 2007, and an increase in the national cure rate from 55 percent in 2005 to
63 percent in 2006- still way below the 85 percent cure rate recommended by the
WHO if goals for reducing the global TB burden are to be met. "We are
moving in the right direction," Tshabalala insisted, "and with the
support of our stakeholders ... we shall be able to reach our targets." Not
everyone at the conference shared the minister's optimism. "There seems to
be some sort of rosy lens that the ministry is trying to put on TB," said
Paula Akugizibwe, a TB/HIV training and advocacy officer with the AIDS and
Rights Alliance of Southern Africa (ARASA), a regional partnership of
non-governmental organisations, based in
Windhoek
,
Namibia
. "It's important to highlight achievements, but we can't let that obscure
the pressing challenges," she commented.
There seems to be some sort of rosy lens that the ministry is trying to put on
TB...It's important to highlight achievements, but we can't let that obscure the
pressing challenges. The emergence
of MDR-TB is widely recognised as the result of failures in the country's TB
control efforts. Drug resistance is usually the result of TB patients not
completing their six-month course of first-line treatment. TB is curable, yet it
is
South Africa
's leading natural cause of death and one of the main factors behind the
country's declining life expectancy. Lesley Odendal of the AIDS lobby group,
Treatment Action Campaign (TAC), presented a critical analysis of the
government's 2007 to 2011 strategic plan for TB, in which she identified
insufficient budget allocations, a failure to adequately address critical issues
like drug supply and infection control, and a lack of detail on how to implement
the goal of integrating TB and HIV programmes as some of the plan's weaknesses.
"There's a lack of accountability structures, decisiveness and sense of
urgency," she told delegates. National Treasurer of the TAC and Executive
Director of the AIDS Law Project, Mark Heywood, went further: "We have a
gap between rhetoric and lack of action," he said. He described the
strategic plan as "an enormous step forward", but worried that it
would be no more than a wish-list if the government did not back it up with
political leadership and resources. "The plan will fail," he said,
unless the government takes a number of steps, including identifying and
implementing emergency measures, coordinating a massive information campaign,
and developing a human-resource plan for TB.
Related stories
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Africa
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http://www.health-e.org.za/news/article.php?uid=20032014&PHPSESSID=8ffb3108b22c9dc67c37cc371a16236a
* State
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* Drug-resistant
TB demands new approaches
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http://www.irinnews.org/report.aspx?ReportId=79086
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