2nd South African TB Conference Durban

Ernest Ramabokela is one of Humana People to People delegates who attended the TB conference in Durban. Mr. Ramabokela highlighted on his report that after attending the conference he sees a big gap in TB work that Humana People to People can fill.

South Africa held its 2^nd TB conference in Durban from 1^st to 4^th June 2010. The theme was “Forging Strategic Partnerships to Fight TB and HIV” and was attended by at least 1800 delegates from different countries. Humana People to People in South Africa had three people who attended.

TB and HIV care was supposed to have been provided under one roof as from the beginning of April this year, according to the new anti-retroviral guidelines announced in President Jacob Zuma’s 2009 World Aids Day speech in December. This promise has not happened. Full TB/HIV integration is needed for optimum health outcomes in TB and HIV patients. It calls for the health care system to mobilize a response that is based on the reality of one patient having two inter related diseases that need the care of one health care worker at a single point of care, rather than the patient having to fit into a mould of an ineffectively designed system. It is where all aspects of TB and HIV care are performed by the same staff at the same facility, as a one-stop service, which yields the most successful results in terms of efficient use of scarce human resources and quality of patient care. Treatment for TB and ARVs has shared side effects. TB immune reconstitution syndrome is a common complication of ART in patients on TB treatment. Earlier initiation of TB treatment and ART prevent mortality. This makes it essential for medical doctors to have information on both treatment in one file or folder.

According to the statement made by Dr Nono Simelele CEO of SANAC, continuing to approach HIV and TB in a vertical approach is denying patients the best benefit of our collective knowledge. The advantages of full TB/HIV integration include providing:

Ø  Increased and earlier detection of both TB and HIV, hence improving treatment outcomes.

Ø  Better intake of ARVs in patients with TB.

Ø  Information on individual patient treatment for both diseases is available in one place, allowing for better clinical management of co-infected patients.

Ø  A single-approach to treatment readiness, adherence support and drug dispensing for TB and HIV.

Ø  Services can be organised to limit the number of appointments for TB/HIV co-infected patients.

Ø  Coherency in the monitoring of both diseases.

It was revealed during the conference that the fight against TB in South Africa has failed children; the share of paediatric TB is increasing, and children have not escaped the rising tide of drug resistant strains. The children under the age of 4 now account for about 9% of all national TB cases annually. The only key to preventing this paediatric TB is by halting adult TB, improving infection control, and access to isoniazid preventive TB therapy.

After attending this conference I see a big gap in TB work that HPP-SA can fill. We need to increase capacity of field officers to provide integrated TB/HIV prevention, early case finding, adherence support, care and social support. We need to increase the community awareness.