We are not going to end TB in South Africa by doing what we have always done which is making speeches about our resolve and then do nothing. The speeches form part of ceremonies spiced with survivors who are turned into celebrities. We need different action and the UN High Level Meeting on Tb (UN HLM TB) should be treated as a global platform where we will be making a commitment and thereafter come back to the country for decisive action.
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. As the South African National AIDS Council (SANAC) Civil Society Forum (inclusive of Labour), we agree that we should all be engaged as active champions in ending TB. We agreed only our actions must count as we have talked enough.
“The snail pace that South Africa is moving in with regards to realizing the commitment to end TB is not appreciated nor accepted – this modus operandi must change. TB can infect and affect anyone, regardless of race, socio-economic status, sexual orientation, gender identity, age or background. So we must all be reminded that TB is not only a health issue, it is an issue for the whole of society. Therefore every government department must play its role, every civil society organisation 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 in South Africa are the following undisputed facts:
- The High-Level Meeting comes at a CRITICAL TIME IN THE FIGHT AGAINST TB.
- 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.
- TB KILLS MORE PEOPLE EVERY YEAR THAN ANY OTHER INFECTIOUS DISEASE and is the ninth leading cause of death globally.
- It is a MAJOR DRUG-RESISTANT INFECTION TRANSMITTED THROUGH THE AIR and the leading cause of death due to antimicrobial resistance.
- 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.
- SOUTH AFRICA DOES NOT INVEST ENOUGH ON PREVENTION PROGRAMMES FOR TB with a focus on a community response.
- 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.
- TB remains a major obstacle to attaining the SDG vision of health, development, and prosperity for all in South Africa.
- TB was South Africa’s NUMBER ONE CAUSE OF DEATH for the last three consecutive years.
- South Africa has:
- 322 000 estimated new cases of TB each year
- An estimated 95 000 missing people with TB
- 14 000 South Africans get drug-resistant TB every year (RR/MDR-TB)
- 78 000 die of TB each year despite it being preventable and curable, and
- Of which 56 000 deaths are among people co-infected HIV die every year according to the 2018 World TB Report,
Yet, with all we know, there are still many problems in acting in ways that ensure that we act in concert to end TB in South Africa because of 2 primary factors viz:
- Funding for prevention of TB in South Africa is not proportionate to 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
We say without any fear of contradiction that the response to ending TB in South Africa needs to involve all spheres of government, not just health departments. TB response needs to involve the private sector that puts people before profit by investing in the workforce and communities that are clients of these private sector entities. TB response also needs an engaged civil society that ensures ongoing community education so that we do not have people defaulting on their TB medication and no one is deemed a “missing TB case”.
We firmly belief that the President and Deputy President of South Africa MUST remind Cabinet Ministers every time they have a meeting that TB requires all political leaders to be involved in its eradication by integrating TB into the mandate of the portfolios they lead. TB response MUST ensure meaningful involvement of Civil Society and TB Affected communities as critical agents to end TB.
We have a crisis on our hands, and this crisis of TB does not know race, class, political affiliation amongst other grounds.
As the President of the Republic, Cyril Matamela Ramaphosa ascends the UN podium on 26 September 2018 to make his speech, he should indicate with pride that as SANAC Civil Society Forum, we fully support the political declaration and we endorse him to append his signature to this declaration on behalf of all South Africans. However, before signing, he needs to come home and ensure that we implement this declaration through doing what we have said in the National Strategic Plan on HIV, TB and STIs 2017 – 2022 and other supporting instruments we have agreed upon as a nation.
Our support to South Africa signing the political declaration is based on ensuring that our EIGHT MAIN ASKS as determined by SANAC Civil Society Forum inclusive of other civil society organisations and TB affected communities. We have respectfully asked for the South African government to elevate these issues using this UN High Level Meeting on TB by reminding all leaders of the world that in South Africa, as part of implementing the global political declaration, at home we commit to:
- Reach all people by closing the gaps on TB diagnosis, treatment, and prevention
- Transform the TB response to be equitable, rights-based, and people-centered
- Accelerate the development of essential new tools to end TB
- Increase domestic and global resources for TB to ensure effective TB programme implementation
- Commit to decisive and accountable global leadership, including regular UN reporting and review
- Task the newly established National TB Caucus to ensure that it has constituted members within six months, with provincial and local representation and consultation mechanisms, and has four meetings per year to review data with input from TB affected communities and civil society.
- We urge the SA government to move rapidly towards quality Universal Health Coverage for all with a special focus on the delivery of integrated and comprehensive community oriented primary care
- Support regulatory system reform
For more information and interviews, contact:
SANAC Civil Society Forum
073 435 6501
SANAC TB Task Team Chairperson
SANAC Civil Society Forum
082 523 7837