South Africa’s government long ignored warnings about drug-resistant tuberculosis, putting millions of HIV-positive people at risk now that a dangerous new strain of TB has emerged, Aids activists say.
South African officials have scrambled to react to news this month that extremely drug resistant tuberculosis, or XDR-TB, has killed at least 60 people in KwaZulu-Natal and is likely spreading, with at least one case found in Johannesburg.
The XDR-TB threat is particularly acute for people whose immune systems are already compromised by HIV — a virus which infects more than five million South Africans, making the country Ground Zero of Africa’s HIV/Aids epidemic.
”There were rumblings about this resistant TB strain several years ago and anxiety that it was going unnoticed [by health authorities]. Now, it’s too little, too late,” said Denise Hunt, director of the Aids Consortium, which represents 1 000 non-governmental organisations.
TB is the leading direct cause of death for South African HIV/Aids patients, some 900 of whom perish daily. The new strain, impervious to the two main TB drugs rifampicin and isoniazid, could push the death toll sharply higher, activists say.
At least 60 people in eastern KwaZulu-Natal have died of XDR-TB, and doctors there report up to three new cases a month. Most of those who have already died in the outbreak have been HIV-positive.
Health authorities — frequently accused by HIS/Aids activists of underplaying the Aids crisis — have vowed to work harder to stamp out the disease. The pressure to act intensified when a case emerged in Johannesburg, the country’s economic heart.
Old problem, new threat
Researchers have known of highly drug resistant forms of tuberculosis worldwide for two decades. But the South African flare-up is worrisome for medical experts because of the high number of casualties in a short period of time.
TB, an airborne bacillus that can be spread through coughing or sneezing, can mutate when patients do not complete or are careless with their treatment or are dispensed inadequate antibiotic cocktails.
Hunt said the government could have headed off this latest strain through a highly focused campaign to inform TB patients about the importance of taking their prescribed dosages on time.
The Treatment Action Campaign, the country’s most vocal HIS/Aids group, said it planned a grassroots education campaign but noted that it must first inform itself on how HIV-positive people could protect themselves against XDR-TB and seek treatment.
In the next two weeks TAC and other activists in the most affected region — KwaZulu-Natal — will organise a campaign that includes door-to-door visits, distribution of educational pamphlets and town-hall meetings.
About 1,3-million of KwaZulu-Natal’s 9,2-million people are HIV-positive.
The Health Department has promised to stock pharmacies in South Africa with an extra TB-fighting antibiotic as early as next week, but said there is no guarantee it can save lives.
Patients who are prescribed the second-line of TB drugs, some of which were developed more than 40 years ago, also can expect to have more severe side-effects than those treated with the first-line antibiotics. – Reuters