Speech by the Northern Cape MEC for Health, Mr Mxolisi Sokatsha on the occasion of the commemoration of World Tuberculosis (TB) Day in Douglas, Pixley-Ka-Seme district, Northern Cape
26 Mar 2010
Honourable Speaker of the Northern Cape legislature
Members of the Executive Council (MECs)
Chairperson and Members of the Provincial Portfolio Committee on Health
Honourable executive mayor of Pixley-Ka-Seme district municipality
The honourable mayor of Siyancuma local municipality
All mayors and municipal councillors present
All non-governmental organisations (NGOs) and strategic partners
Senior managers, district managers and departmental officials from government departments
Representatives from all the different NGOs, community and religious institutions and structures across the province
Members of the media
Ladies and gentlemen
Our beautiful community of Douglas, Pixley Ka Seme district and Northern Cape province
Dumelang, good day, molweni, goeie more!
It is an honour and privilege to address you this morning on the occasion of the commemoration of World TB Day. Programme director; allow me to first acknowledge exceptional work and contribution by one of the Northern Cape daughters, Ms Mavis Kedibone Malelane.
On behalf of the provincial Department of Health and the Democratic Nursing Organisation of South Africa (DENOSA) we marks this provincial TB Day commemoration by congratulating Ms Mavis Kedibone Malelane (in absentia) as this year’s recipient of the International Council of Nurses (ICN)/Lilly Award for Nursing Excellence in the field of multi-drug resistant (MDR) TB in South Africa.
Today, on 26 March 2010, Ms Mavis Malelane will be handed her prize by the Deputy President, Honourable Kgalema Monthlante, at the national TB celebrations in Gauteng. As the Department of Health and DENOSA we wish to encourage all other nurses to follow the example set by our National winner, Mavis Malelane, even though we all realise that the circumstances under which they work are challenging. In addition, I would like to congratulate our stakeholders, partners and the TB programme for organising this important event.
Ladies and gentlemen, 24 March every year marks the day in 1882 when Dr Robert Koch astounded the scientific community by announcing in Berlin the discovery of the cause of tuberculosis, the TB bacillus. This discovery opened the way towards diagnosing and curing TB. It is through this breakthrough that World TB day is commemorated every year on the 24 March and is designed to build public awareness that TB remains an epidemic in much of the world, causing the death of millions of people especially in developing countries.
According to the World Health Organisation (WHO) report of 2009, Global Tuberculosis Control: Epidemiology, Strategy and Financing, South Africa’s case detection rate has remained above target since 2003. We have not made much progress in tuberculosis control. Treatment success rates have remained low. We have high default and death rates.
South Africa reports the highest number of confirmed multi-drug resistant tuberculosis (MDR-TB) and extreme drug resistant tuberculosis (XDR-TB) in the Southern African Development Community (SADC) region. TB prevalence has increase almost three fold in the last ten years. South Africa is amongst the 10 worst performing countries on TB control.
Our performance is worse than those of our neighbours, like Mozambique, despite the fact that we have better resources. We are in danger of not meeting our millennium development goals (MDGs) as a result of these poor outcomes.
Programme director, I would like to take this opportunity to provide a picture of TB in the Northern Cape, we are also faced with the challenge of TB. TB, coupled with the HIV and AIDS prevalence is spreading at an alarming rate through our communities with an increased number of people contracting TB coupled with patients not completing and faulting on their medication.
The Honourable Premier of the Northern Cape, Ms Hazel Jenkins, noted in her State of the Province Address on 18 February 2010 stated that: “As TB is a public health challenge it requires the participation of stakeholders to reduce new infections”.
The scourge of TB in the province is marked by the increased incidence and prevalence rate, the number of deaths, MDR-TB and the emergence of XDR-TB which is further exacerbated by HIV and AIDS. The number of new TB cases increased from 6127 in 2004 to 8192 in 2008. This marks an increase in the TB incidence rate from 552 per 100 000 population to 738 per 100 000 population.
Both Namaqua and John Taolo Gaetsewe districts have maintained the highest cure rates namely above seventy percent (70 percent). The Frances Baard and Siyanda districts still remain crisis districts due to poor treatment outcomes. Pixley ka Seme district has been performing above average in terms of cure rates but the increasing treatment failures and defaulter rates are a cause for concern.
I am stating these facts to make us aware that we need a change of mind set and more sense of urgency to confront the scourge of TB. Program managers whose responsibility is to implement government programs against TB and our partners whose daily work is to assist us as a province and districts to deliver better health outcomes should not only be satisfied with drafting crisis plans. All should work in partnership to ensure that society gets involved in our fight against TB, as we have declared this a priority disease.
The prevention and control of TB is still a challenge and thus warrants the continuous engagement of politicians, government, business, private sector as well as civil society to address the negative impact of TB in communities. The objectives of the national strategic plan 2007 to 2011 for TB spells out clearly how TB can be controlled in the province and the country through advocacy, communication and social mobilisation. The objectives of the national strategic plan for TB include amongst others; empower communities around TB through the advocacy, communication and social mobilisation strategy.
Advocacy, communication and social mobilisation are critical to the success of any efforts to control TB and aims to:
- mobilise decision makers’ commitment to TB control
- increase awareness and knowledge about TB
- improve case detection and treatment adherence
- influence behaviour change
- improve quality of health
- empower people affected by TB.
Ladies and gentlemen, as a country and a province, we are going to host and be part of the most prestigious sport event in the world this year namely the 2010 FIFA Soccer World Cup. As the Northern Cape provincial government we want to encourage all to be part of this spectacular event and support the “Football Friday” campaign by wearing your Bafana-Bafana soccer shirts on Fridays.
In line with the 2010 FIFA Soccer World Cup, the theme for World TB Day 2010 is: “On the move to Kick TB out”. During the 2010 TB campaign we aim to involve scholars in the fight against TB, promote healthy lifestyle and support the build-up activities towards the 2010 FIFA Soccer World Cup as well as lobby political support in the fight against TB.
As part of World TB Day 2010, we are planning to identify TB ambassadors in all districts across the province. These ambassadors can be any person, preferably a role model, celebrity or political leader who had TB and successfully completed treatment. These TB Ambassadors will give motivational talks on early identification of signs and symptoms of TB, compliance to treatment, treatment support and infection control. Despite, the above mentioned interventions in an attempt to overcome TB challenge, I want to reiterate that we must always be reminded that TB is curable.
We call upon patients not to stop TB treatment until a healthcare worker has indicated to you to do so. TB treatment has been designed in such a way that is requires regularity, accuracy and endurance, otherwise it will not work. What we found in our efforts to combat TB, there is the lack of commitment and responsibility from our patients during their treatment. These include:
- When people have TB symptoms they do not immediately go to the nearest clinic to test themselves, further more;
- Many of our people still do not complete their TB treatment, which is important if you want to be cured; and if you don’t want to get more serious forms of TB
- Many people still live in places that are not clean and some do not undertake simple steps such as opening of the windows at home in the morning to allow for fresh air.
Programme director, it is reported that some people do not want to take their medication. They don’t want to be cured because they want to benefit from the temporary disability grant. However, what they forget is that they may also die as a result of their behaviour.
In addition, I want to highlight part of our efforts to combat TB which is the TB Defaulter Tracing programme. We achieved great success with the programme. In 2008, the defaulter rate was five point nine percent (5.9 percent) compared to defaulter rate of thirteen percent (13 percent) in 2007. TB tracer teams have been established in all districts across the province and compose of nurses and community health workers whose task is to follow-up patients that default on their TB treatment. These teams’ visits homes to find patients and put them back on treatment.
Ladies and gentlemen, we can all help people who have TB by becoming a directly observed treatment (DOT) supporter and help patients take their TB medicines. You can ask at your local clinic how you can help. We must respect people with TB just as you respect everyone else or one can join organisations which help people with TB. Parents need to ensure that their children receive a Bacille Calmette Guerin (BCG) vaccine at birth.
Ladies and gentlemen, we call upon all to support the 2010 FIFA Soccer World Cup, Bafana-Bafana as well as the World TB Day 2010 campaign under the theme: “On the move to Kick TB out”, because tuberculosis is preventable and curable, yet our people still die from this scourge. To fight TB, we require the efforts of every South African, to stand together; therefore I call upon everyone to pledge that:
- I will go for an examination if I cough for longer than two weeks
- I will advise anyone who coughs for more than two weeks to go for an examination
- I will take my treatment until the end I am diagnosed with TB
- I will help TB patients take their medication everyday and
- I will ensure that my action does not stigmatise TB patients.
On the move to kick TB out
In conclusion, we should accept that we are not making good progress. We run the risk of not being able to meet our millennium development goals. We need to redouble our efforts and improve our outcomes. Let us remember that TB is more than a medical problem.
It is worsened by poverty and poor socio-economic conditions, poor nutrition, overcrowded housing, and poor working conditions such as in dust filled mines and general stress. Solutions will therefore always require multi-sectoral partnerships that straddle government, communities, researchers, civil society organisations, academic institutions, researchers and communities in general.
In this regard, we wish to acknowledge the contribution of our partners namely, Khomanani, TB FREE, pharmaceutical companies, the farming sector, religious sector, municipalities, the Department of Correctional Services, the South African Defense Force (SANDF), community structures, NGOs and community based organisations (CBOs) as well as Pathfinder, Love Life and New Start who render peer education, condom demonstration and distribution and voluntary counselling and testing (VCT) services at health facilities.
It is our civic duty, our obligation and our responsibility as citizens to contribute efficiently and constructively to create communities and a society that is free from TB. We value your partnership. We believe that together with you, we can do more.
Issued by: Northern Cape Health
26 Mar 2010
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