TB is killing us

Tuberculosis should be declared a public health emergency and "war rooms" should be set up in each province to deal with the disease.

And President Jacob Zuma should be compelled to explain to the SA National Aids Council the government's plans for dealing with the scourge and the progress being made.

These calls were made yesterday by NGOs - the Treatment Action Campaign, Section 27 and Médecins Sans Frontières - ahead of the start of the national TB conference in Durban today.

According to Section 27, there are 1400 TB infections daily.

The activists say that drug-resistant TB is on the rise and only 40% of victims of the deadly disease, for which there is a shortage of effective medicine, survive.

Schools have become sources of TB and drug-resistant TB infection.

The government says it needs a further R2-billion to meet its 2016 targets of reducing the spread of TB and HIV.

This is according to the researchers and activists who want to use the conference to motivate doctors to support their call for urgent government action.

"Declaring TB, and the growing threat of drug-resistant TB, an emergency would require immediate action by the government to [stem the tide]," said Section 27 lawyer John Stephens.

TAC chairman Anele Yawa said drug-resistant "TB is out of control". Only half the patients with the drug-resistant form of the disease received treatment - which can cause hearing problems or complete deafness - in 2012.

Yawa called for civil action to force the government to deal with the problem more effectively.

He said the HIV tide was turned when it was treated as "a threat to life on a massive scale, requiring a response on a massive scale. We need a similar response to drug-resistant TB".

Activists want the government to set up "war rooms" in the provinces to ensure that doctors, researchers, NGOs and funders collaborate in the treatment of patients, and in detecting and supporting people with the drug-resistant form of the disease.

Dr Bhavesh Kana, head of the National Research Foundation Centre of Excellence for Biomedical TB Research at Wits University, said the World Health Organisation had declared the "scourge" of drug-resistant TB an emergency.

He said the government should follow suit.

In South Africa, the use of more than 68 of the newly introduced GeneXpert machines, which can detect drug-resistant TB in only two hours, has shown researchers that drug resistance is much worse than had been thought.

Dr Lindy Dickson-Hall, a medical microbiologist at the University of Cape Town, said researchers believed the prevalence of the disease would get worse because it was highly infectious.

"Drug-resistant TB used to be a disease that developed if patients defaulted on treatment. Now patients contracting TB for the first time [also] get it."

Stephens said: "The government knows what to do to slow the spread of TB but [it] lacks political will."

Problems facing doctors and patients:

• Treatment for drug-resistant TB takes two years and patients take about 25 tablets a day;
• Side effects of treatment include psychosis, vomiting, deafness;
• Newer drugs are extremely expensive or are not yet available in South Africa;
• TB must be treated by multiple drugs but there is little global research on developing new combinations;
• Patients stop the treatment too early, as soon as they feel better;
• Many patients who test positive for drug -resistant TB do not return to the clinic and cannot be contacted;
• Patients test repeatedly, in different provinces, skewing the incidence data;
• Tested patients return to a clinic for treatment to find no doctor available to prescribe it;
• When clinics are out of stock treatment is delayed; and
• There are not enough hospital beds for drug-resistant TB patients.
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