By Lehlohonolo Lehana.
Health Minister Joe Phaahla has revealed that South Africa is still the epicentre of the Aids pandemic, with skyrocketing infections.
Phaahla revealed this at the 11th health conference held in Durban.
The conference was held under the theme “Act, Connect and end the epidemic” for a good reason.
“South Africa is on the three global lists of high-burden countries for TB, HIV-associated TB, and drug-resistant TB. The World Health Organization (WHO) estimates that over 110 000 people with TB in South Africa lost their lives between 2020 and 2021,” he said.
Phaahla said since 2010, over one million South Africans were estimated to have succumbed to TB, which is preventable and curable.
The health minister also said the Covid-19 pandemic and associated lockdowns severely impacted TB services throughout the country.
He added:Between 2019 and 2020, the number of TB tests provided in South Africa decreased by 23% and case notifications decreased by 25%. There has been some recovery since 2022, but it is estimated that the pandemic has reversed 12 years of global progress against TB.
Phaahla said after extensive consultation with all stakeholders, the health department developed the TB recovery plan.
The TB recovery plan is a target-driven, evidence-based plan aimed at finding people with undiagnosed TB, strengthening the linkage of people diagnosed with TB to treatment, strengthening retention in TB care and strengthening TB prevention.
He said South Africa was at the forefront of TB research and development. There were some new interventions and exciting developments, including expanded screening activities with TB health checks, as well as the use of digital chest X-rays for TB screening.
“For the people with undiagnosed TB, we plan to screen a million people, 60% PLHIV tested and notification of 215 900 patients through annual TB tests. This will be augmented by 300 000 chest X-rays screening. We will also introduce TB results notification system to patients via SMS to improve linkage to treatment. We will soon be using new molecular diagnostic tests for TB,” he added.
He mentioned the department planned to put 85% of the lab-diagnosed patients on treatment, and wished to retain 86% of the drug-susceptible TB on treatment through strict adherence to treatment programmes.
We are also planning an introduction of more patient-friendly treatment regimens (four-month paediatric drug-susceptible TB and six-month drug-resistant TB regimen) to improve retention in care. A TB vaccine is advancing to a phase III trial in South Africa, with promising results.
He stated the department further wanted to scale up the implementation of new TB preventive therapy, including 3HP (three months of weekly rifapentine and isoniazid oral treatment) to improve TB-prevention and reduce transmission, especially among household contacts.
Phaahla added the department is aware of the need to scale up some of its HIV interventions.
“Our HIV combination prevention interventions such as PrEP, CAB LA, Dapivirine vaginal ring, PEP, condom promotion, integration of family planning and SRH and STI management need to be scaled up.
“The implementation of the national strategic plan will require serious adjustment of the clinical guidelines such as changing from prevention of mother-to-child Transition to prevention of vertical transmission.
“This will result in increased access to optimised ART regimens, and provision of better therapeutic for pregnant women. In this way, there will be lesser risks for neural tube defects and will focus strongly on achieving and maintaining maternal viral load suppression.”
He adds that infants will be given dual prophylaxis at birth.
“Through this programme, all babies will receive dual prophylaxis at birth until the results of the delivery viral load are known. Once the delivery viral load is known, the threshold for defining ‘high-risk’ would have been achieved.
“This will lead to the prevention of more babies born infected and thus reduce the expenditure on the treatment. From these developments, it is evident that a focus will be on preventing HIV infection, thus achieving and maintaining maternal viral load suppression; keeping HIV-exposed infants in care with PCR testing as per guidelines, and ultimately ART initiation in the small proportion of children who do become HIV infected.”
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Video Courtesy of SABC.