The 2021 Global TB Report by the World Health Organisation (WHO) notes that over 1 million children were diagnosed with TB worldwide in 2020 and a quarter of these children died from the disease.
Dr Karen du Preez from the Desmond Tutu TB Centre, addressing the SA TB Conference in Durban, says of those children, only 400 000 were noted by the WHO as being on treatment.
Du Preez also touched on the number of undetected cases of children infected with TB.
“We’re still missing a lot of younger kids so estimates that about 70% of our younger kids we’re still missing. So we really need to focus on diagnosing these children… We have to get the basics right. There’s nothing that beats good history, clinical evaluation and close follow-up. It’s a really powerful tool that works with children. And we really need to equip our health care workers to be confident in diagnosing TB-positive children at the primary health care level.”
Stakeholders at the SA Tuberculosis Conference in Durban say that TB can only be eliminated through a collaborative approach minus the silo mentality. Health care experts, civil society and government came together to examine why the current systems for testing and treatment are not yielding significant results.
It’s going to take all of us, and not some of us. That’s the message from doctors, TB advocates, health care funding organisations and government, on how South Africa can push on in the fight to eliminate TB.
The WHO lists South Africa among the top 30 high TB burden countries, with a high HIV-TB co-infection rate of over 60%.
Alongside earlier calls at the meeting for greater investment in diagnostics to shorten the test-to-treatment gap, voices across the TB landscape are confident that solutions lie in and within communities most impacted by TB.
The Treatment Action Campaign (TAC) Ritshidze Model is an example of this. The goal of the community-led monitoring project is to hold governments and aid agencies accountable by monitoring community and health care centres across the country.
TAC’s Butho Mpofu says, “Ritshidze project is currently monitoring over 400 clinics and community healthcare centres across 29 districts in 8 provinces of SA. We would say this is the largest community-led monitoring campaign in the world and it’s going to get even bigger. We are going to add 200 more sites within the next year.”
Stakeholders discuss airborne diseases at 7th South Africa TB conference in Durban.
A similar message from the director of Show Me Your Number, Mabalane Mfundisi. The organisation is part of the South African National Aids Council civil society forum.
“They live amongst us and we cannot find them and when we find them they must be provided with services. Not only at the facility level but we must take facilities to where the people are. It’s 1 thing to say we have the medication but it’s another that it’s actually unaffordable,” explains Mfundisi.
Key questions were raised by Dr Enos Masini from the Global Fund. The fund is a global partnership to defeat TB, HIV and malaria. South Africa is among the countries it provides funding to fight TB. Masini however questioned why South Africa was still suffering from a lack of policy implementation.
Masini says, “We have evidence-based interventions and the rollout of new tools but why do we still have a relatively large number of people with TB missing from care? The tools and innovations by themselves will not be able to reach the people. And therefore there must be continuous improvement, effective implementation to ensure the tools do what they are meant to do.”
Wide applause followed calls from civil society for tuberculosis to be declared a national health emergency in South Africa.
The global TB mortality rate remains alarmingly high despite the disease being curable.
Over 4 100 people die from TB around daily
Chief research officer from the University of Cape Town, Dr Angelique Luabeya says the world needs a TB vaccine to reduce mortality by 95% before 2035.
Statistical data by the Joint United Nations Programme on HIV/AIDS-UNAIDS has revealed that over 4 100 people die from TB around the world, daily.
Luabeya says the long-standing BCG vaccine is not strong enough, as it does not protect against the critical pulmonary TB.
“We need a TB vaccine, the current tool that we have will not help us reach the target. But if we introduce the new TB vaccine It might accelerate our efforts to the target by 2035. But we have to ask ourselves why is it taking us so long to have a TB vaccine, we have a BCG vaccine, which is 100 years old. This has limitations in reducing or control the TB epidemic.”