South African medical authorities need to start thinking about tuberculosis (TB) and HIV/Aids as a single epidemic, rather than treating them separately, a TB expert said on Tuesday.
Dr Greg Hussey, head of the University of Cape Town’s Institute for Infectious Diseases, was speaking at a media briefing ahead of a major international conference on lung health, which begins in the city on Thursday.
He said about 250 000 new cases of TB are reported every year in South Africa, and that number is growing. Probably more than half of them are also HIV-positive.
The diseases should be seen not as parallel epidemics, but as one epidemic, requiring a single intervention.
He said that while the World Health Organisation’s target is an 85% cure rate by 2015, and the rate in Cape Town is currently 79%, it is only about 50% in the country as a whole, which is ”a disaster”. In parts of Mpumalanga and KwaZulu-Natal it is as low as 30%.
Hussey said problems with multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB reflect the failure of South Africa’s national TB-control programme. Had those patients been diagnosed earlier and treated appropriately, they would not have developed those extreme forms of the disease.
TB should be seen as not only a medical but also a social problem, requiring a correspondingly broader approach. ”We need to start thinking out of the box at the end of the day,” he said.
Treatment
Hussey said health authorities also need to rethink the strategy of putting MDR-TB and XDR-TV patients into institutions for treatment, and consider whether they can instead be treated in the communities where they live. He said the resistant strains of TB are no more infectious than ordinary TB.
Greg Gonsalves of the Aids and Rights Alliance for Southern Africa said that with its massive HIV prevalence levels, South Africa should be providing leadership to the entire region in the fight against TB. ”And if you look at facts and figures, it’s not there,” he said.
He said TB testing of HIV-positive people should be stepped up and made much more convenient.
There should be a public education campaign on simple infection-control measures, such as opening windows in crowded rooms or taxis, or having people cover their mouths when they cough. Also, the heads of government HIV/Aids and TB programmes should harmonise their activities.
Gonsalves said there is a need for new diagnostic tools and new drugs, but added that TB can be cured with what is available.
Boniswa Seti, a treatment literacy coordinator for the Treatment Action Campaign, said communities should be given an active role in dealing with the disease. — Sapa