SANAC Civil Society Forum Draft Position Paper on UN TB HLM

SANAC CIVIL SOCIETY FORUM

TB TASK TEAM, CSOs and TB Affected Communities DRAFT Position Paper on TB HLM

  • September 2018
  1. PREAMBLE

Goal 6 of South Africa’s National Strategic Plan on HIV, TB & STIs 2017 – 2022 (NSP 2017 – 2022) puts emphasis on the extreme high level of commitment to accountable leadership which speaks to shared leadership in our HIV and TB response. We all agree in SANAC that in all spheres of government, civil society and business, we must be engaged champions in ending TB.

The snail pace that South Africa is moving in with regards to realize the commitment to end TB is not appreciated nor accepted – this modus operandi must change. TB can infect and affect anyone, be they heterosexuals, homosexuals, bisexuals, transgender and intersect people. So We must all be reminded that TB is not only a health issue, it is a whole of society issue. Therefore every government department must play its role, every civil society organisations must play its role, every business must play its role, and every community member must play their role in ending TB” says Steve Letsike, Chairperson of SANAC Civil Society Forum and Co-Chairperson of SANAC.

WHAT WE KNOW ABOUT TB

  1. The High-Level Meeting comes at a CRITICAL TIME IN THE FIGHT AGAINST TB.
  2. At the current rate of progress, IT WILL TAKE 150 YEARS TO ACHIEVE THE TARGET OF SUSTAINABLE DEVELOPMENT GOAL (SDG) 3.3 to end the TB epidemic.
  3. TB KILLS MORE PEOPLE EVERY YEAR THAN ANY OTHER INFECTIOUS DISEASE and is the ninth leading cause of death globally.
  4. It is the ONLY MAJOR DRUG-RESISTANT INFECTION TRANSMITTED THROUGH THE AIR and the leading cause of death due to antimicrobial resistance.
  5. TB IS A CAUSE AND CONSEQUENCE OF POVERTY, and its deadly persistence demonstrates the imperative of supporting the research and development (R&D) of new health technologies and ensuring their accessibility and affordability to all people in need.
  6. SOUTH AFRICA DOES NOT INVEST ENOUGH ON PREVENTION PROGRAMMES FOR TB with a focus on a community response.
  7. For these reasons, TB SITS AT THE HEART OF THE SDGS, MAKING PROGRESS AGAINST TB AN ESSENTIAL MEASURE OF THE SUCCESSFUL REALIZATION OF THE SDG agenda at large.
  8. TB remains a major obstacle to attaining the SDG vision of health, development, and prosperity for all in South Africa.
  9. TB was South Africa’s number one cause of natural death for the last three consecutive years.
  10. South Africa has:
    1. 438,000 estimated new cases of TB each year
    2. 160 000 missing TB cases
    3. 19,000 of these are drug-resistant,
    4. 23,000 die of TB each year despite it being preventable and curable, and
    5. 101, 000 approximately people co-infected with TB and HIV die every year according to the World TB Report,
  11. Yet in South Africa
    • Funding for prevention of TB in South Africa is negligible given the urgency of our TB crisis.
    • Funding for research on TB in South Africa is not sufficient given the urgency of our TB crisis. New tools to prevent, diagnose, and treat TB are urgently required.                                                                                                                                  WHAT WE AGREE ON
  1. TB transmission happens in the whole of South Africa. It happens occurs mostly in:
    1. Workplaces
    2. Early Childhood Development and Schools
    3. Public transport
    4. Informal settlements
    5. Large Infrastructure Projects that does not include Environmental Impact Assessment
    6. Healthcare facilities, including those of the Department of Health at all levels.
  2. On the 19th March 2018 the Treatment Action Campaign released shocking findings from its survey of TB infection control at healthcare facilities in South Africa (https://tac.org.za/news/red-alert-on-tb-infection-control-in-clinics/).
  3. TB response needs to involve all spheres of government, not just health departments. To this end, the President and Deputy President MUST remind Cabinet every time they meet in Cabinet that TB requires all political leaders to be involved in its eradication by integrating TB into the mandate of the portfolios they lead.
  4. TB response MUST ensure meaningful involvement of Civil Society and TB Affected communities as critical agents to end TB.
  5. We have a crisis on our hands, and this crisis of TB does not know race, class, political affiliation amongst other grounds
  6. It does not care about our beliefs
  7. It has no regard for our egos
  8. The crisis needs us to work and walk together to end the TB pandemic.
  9. Hiding behind beaurocracy and romanticising with celebrities will not end TB – this crisis is about the whole of society.

 OUR ASKS – HOLDING HANDS WITH RSA GOVERNMENT

The UN High-Level Meeting has to be seen as an opportunity to raise the political commitment of TB domestically.

  1. So WHAT MUST WE COLLECTIVELY DO AS WE GO TOWARDS UN HIGH LEVEL MEETING AND BEYOND?
  2. We have a full soccer team of 11 asks as determined by SANAC Civil Society Forum inclusive of other civil society organisations and TB affected communities. We respectfully ask for the South African government to elevate these issues to the highest level of political dialogue in advance of and during the High-Level Meeting:

 23.1 Reach all people by closing the gaps on TB diagnosis, treatment, and prevention

23.1.1 All high-burden countries should commit (as SA has done) to introduce 3HP for prevention, Xpert for TB diagnosis, TB LAM for diagnosis of TB in people with advanced HIV, decentralization of DR-TB care, and introduction of injectable-free regimens for DR-TB.

23.2 Use of TRIPS flexibilities to ensure accessibility and affordability to TB Treatment

23.3 Transform the TB response to be equitable, right-based, and people-centered

23.4 Accelerate development of essential new tools to end TB

23.4.1 All high-burden and G20 countries, including all BRICS countries, should commit 0.1% of all gross domestic expenditure on R&D to TB R&D

23.5 Increased domestic and global resources for TB to ensure effective TB programs implementation

23.6 Commit to decisive and accountable global leadership, including regular UN reporting and review

23.7 Task the newly established National TB Caucus to oversee TB program progress and influence effective implementation, including building out concrete accountability; monitoring and evaluation mechanisms with input from TB affected communities and civil society

23.8 We urge SA government to fund the employment of sufficient numbers of community healthcare workers and other healthcare system employees required for a scaled-up TB response that includes widespread active case-finding and contact tracing programmes, and provision of counseling and other support.

23.9 Concrete and urgent steps (prevention and treatment of TB) should also be taken to ensure the health and safety of health workers and those they care for. This includes the urgent finalisation and release of the Policy on Occupational Health for health workers in respect of HIV and Tuberculosis.

23.10 Support regulatory system reform: Ensure adequate funding for fully staffed regulatory authorities, to ensure rapid registration of priority TB drugs and diagnostics, and facilitate establishment of rapid registration mechanisms (including collaborative registration mechanisms with WHO and other stringent regulatory authorities)

23.11 Support initiatives specifically targeting TB- & HIV-related stigma and discrimination by community organisations and individuals – like the initiative of Miss South Africa 2018 (#BreakTheStigma), be they celebrities or ordinary people including those that will be led by engaged MPs, MPLs and Councillors who have signed the SA TB Caucus Pledge.


PRE-TB HLM ACTIONS:-

  1. SANAC Civil Society Forum is the voice of civil society on matters of HIV, TB and STIs.
  2. With regards to issue of TB, the SANAC Civil Society Forum established TB Task Team in 2016 with a mandate to lead the TB agenda and be inclusive in each approach. We have had challenges of leading the agenda but we have been inclusive.
  3. We fully support the SA Parliamentary TB Caucus and we will work and walk with Parliamentarians to realise the spirit and letter of the Pledge at community level.
  4. We have incorporated addressing TB issues in the National Wellness Campaign through the implementation of DISTRICT ROLLOUT ACTIVATIONS
  5. The energy of the UN High Level Meeting has energized us and we will succeed going forward as we drive the agenda in an inclusive manner. To this end, we will:
  6. Convene a diverse and inclusive national consultation in advance of the High-Level Meeting to inform the selection of the national delegation and the development of priority actions and commitments to take forward to the UN TB HLM. We are Leaving No One Behind .
  7. Share the SA Political Declaration online with the rest of society to ensure the TB affected communities and civil society groups in SA are engaged with issues.
  8. We will develop a platform that will include wide representation from TB affected communities and civil society groups in SA.
  9. Create stronger ties with Parliament through the Portfolio Committee on Health and other Portfolio Committees to ensure the pledge signed by MPs (which should cascade to MPLs and Councillors) is not just a document, but a living resolve to END TB by South Africa political leaders working with civil society
  10. Hold ourselves accountable and hold government accountable for commitments made.

… END…

Please send comments or inputs to sanac.csf@gmail.com no later than Monday 17 Sep 2018.




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