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Civil society calls for ramped-up TB services by Christmas

Image: wilpunt, via Getty Images

But government instability after South Africa’s dramatic election could delay action, expert warns

Civil society organisations have demanded that South Africa ramp up testing and treating of tuberculosis by the first of December this year.

The call comes in an open letter to Joe Phaahla, the health minister, published on 7 June, the final day of the 8th South African TB Conference held in Durban.

The letter demands that the government increase TB testing, prevention and treatment measures, but that it also improves access to psychosocial interventions like counselling and nutritional support for affected families.

Limakatso Lebina, a TB clinical trials specialist at the Africa Health Research Institute who was on the conference organising committee, told Research Professional News that she thought their demands were “reasonable and necessary”.

However, she said she doubts the 1 December deadline will be met as political uncertainty threatens ministerial positions following the recent national polls.

Election uncertainty

On 29 May, South Africa held an election where the ruling African National Congress lost its majority in parliament.

With political parties exploring coalition options, it is not clear whether Phaahla, who has retained his parliamentary seat, will return as health minister.

In their open letter, organisations including South African National AIDS Council Civil Society Forum, TB proof and Show Me Your Number expressed their hope that he will.

“However, if this is not the case, make sure you provide to the minister who will take over from you this letter and advise him to act with greater speed than you did,” they write.

Cross-cutting needs

Lee-Ann Davids, head of monitoring, evaluation and research at the South African Medical Research Council’s office for Aids and TB research, said the Durban conference agreed on the need for a more cross-cutting approach to the disease.

“The conference was unanimous in its conclusion that a comprehensive and multi-sectoral approach will be required to accelerate our progress in ending TB as a public health threat,” she told Research Professional News.

She and Lebina said experts agreed that although South Africa has made great progress in biomedical interventions including vaccines, drugs and diagnostics, the focus must shift to include areas like affordability, social services and food parcels.

“It is not just about the free TB treatment once one is diagnosed. The big cost is accessing diagnosis,” said Lebina, citing the cost of multiple health facility visits and tests.

Details needed

Lebina said that while South Africa has good policies in principle to facilitate a cross-sectoral TB response, researchers still need to figure out the details of implementation.

For example, she said, while it is easy to say nutritional support is needed, there are questions around the type of support and possible associated stigma. “Is it a food supplement? Is it a food parcel? Where should they be collecting it? What is the stigma if there is a delivery van going to certain families? Would that bring more stigma and discrimination for those families?”

Lebina also indicated that research and funding is still needed for biomedical interventions, including developing improved TB vaccines and finger-prick diagnostics.