South Africa is one of the countries hardest hit by the global tuberculosis (TB) epidemic, that will take at least 180 years to eradicate at the current rate of improvement, according to Health Minister Aaron Motsoaledi.
Infectious bacterial disease
To help speed up the rate of improvement, the Stop TB partnership, of which Motsoaledi is the co-chair, has launched a new Global Plan to end TB. It aims to diagnose and treat 90% of all TB cases and to get 90% of those diagnosed with TB to complete their treatment.
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The Global Plan outlines that investing $56bn over the five years 2016-2020, would bring treatment to 29 million patients, save over 10 million lives and prevent 45 million people from getting infected with the world's biggest infectious killer.
TB is an infectious bacterial disease that most commonly attacks and damages the lungs. The symptoms of active TB of the lung are coughing, sometimes with sputum or blood, chest pains, weakness, weight loss, fever and night sweats. Tuberculosis is treatable with a six-month course of antibiotics.
Motsoaledi said at a press conference, where health ministers and parliamentarians from around the world met to formally lend their support to the Global Plan, which South Africa already started implementing last year.
He said TB is part of the focus of the SA National Aids Council and the government has identified groups most vulnerable to TB such as prisoners and mine workers.
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"The first thing which is changing in South Africa is that we've been able to outline which are the most vulnerable populations in the country who is more vulnerable to get TB."
Motsoaledi noted that the three groups identified are people in correctional services, people working in the mines and people living in 6 districts, which have intense mining activity.
Screenings at own expense
He added that on February 24 Deputy President Cyril Ramaphosa also launched what is regarded as South Africa's biggest ever TB screening programme.
Workers on the gold mines are particularly vulnerable to TB, said the minister. "We said the mining bosses themselves must do the screenings. All we did was to hire 9 inspectors who are going from mine to mine to make sure that they are screening. They have just informed us last month that at least 90% of the mines in South Africa are doing that screenings at their own expense," he said.
"In the correctional services, we've already conducted 517 000 tests since March because we screen them when they enter, two times when they are inside and when they leave the correctional services."
Seven correctional services facilities which carry 30% of the inmate population in the country also have GeneXpert technology, which has revolutionised TB diagnoses. GeneXpert changed the diagnosis of TB, MDR TB and XDR TB to just 2 hours from a week and three months respectably.
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"SA is one country which has the most widespread GeneExpert technology than any other. We are number one in the world. In fact 50% of the tests in the whole world have been conducted here in SA."
A huge battle
Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, said two years ago when she came to South Africa it came as a surprise that GeneExpert technology was placed in prisons because countries were using it in their main national labs.
"It was extremely unique and that was just one of the moments in which you realise that you need some strong leadership. What is extremely important and what we all try to have is the political leadership and understanding. You need force to change the epidemic and it is a huge battle."
Another change that South Africa implemented was to decentralise TB treatment.
"In 2009, we officially opened 9 MDR TB hospitals where all people with drug resistant TB must stay, but now we are following the instructions from the World Health Organisation that we need to decentralise it to communities. We now have more than 500 facilities around the country that are treating MDR TB."
Patients have also been placed on a bedaquiline programme in the country, said Motsoaledi. "The whole world has got 1 500 people on it of which 1000 people are here in the country."
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