Hon Chairperson of the NCOP, hon Ministers and Deputy Ministers present, Chairperson of the Portfolio Committee on Health and also the Chairperson of the Select Committee for Social Services in the NCOP, hon members, thank You very much for this opportunity to participate in this debate on TB in the month of March when we focus on
Tuberculosis - with World TB Day taking place on 24 March every year.
Hon members, I bring you greetings also from my colleague Minister Mkhize who I left in Polokwane last night together with other members of the Executive together with the leadership of Limpopo province, including the premier who was busy putting final touches on the return of South African citizens who are being repatriated from Wuhan City in China.
I just want to report also to the House that in the process of our engagement during the course yesterday, we were able amongst others to have an audience with the leader of the biggest church in Southern Africa, His Holiness Bishop Barnabas Lekganyane who pledged full support for government's support to curb the spread of Coronavirus and also to work with the government in the coming challenges around a mass gathering, including the Easter gathering in Moria City.
Hon members, I wish to draw your attention to the fact that Tuberculosis and Coronavirus share some similarities but there are also a number of differences. While TB is caused by bacteria called Mycobacterium Tuberculosis, Covid-19 is caused
by a virus as we know Coronavirus. Whilst TB is an ancient disease, Covid- 19 was only discovered on 17 January this year, 2020.
While we know a lot about TB, we know very little about Covid-
19. We have the diagnostic tools and drugs to diagnose and treat TB and cure it, including drug resistant TB, but we don't have a cure for Covid- 19. We have a vaccine called BCG which is almost 100 years old to prevent TB, which is effective in at least 60% of those who have been vaccinated. But as of now just to emphasise there is no vaccine for Coronavirus for Covid-19.
But despite these differences, there are also similarities between TB and Covid-19, both are spread by droplets. That means coughing and sneezing; both affect the respiratory system; and both can be prevented by similar public health measures like coughing and sneezing either into your sleeve or into the crook of your arm or into a tissue paper or handkerchief to avoid the spread of the disease.
Social distancing is another method to limit the spread of the disease, standing around a metre away from other people. As we
have seen in Italy and other countries in Europe, unfortunately hon members, this social distance and avoidance, includes unfortunately kissing ... [Laughter.] ... shaking of hands, avoiding kissing and shaking of hands is also recommended.
Proper ventilation in homes, schools, busses, taxis and trains etc, is critical to ensure that when people congregate they don't infect each other with TB in the same way as Coronavirus. So, we must encourage everyone to ensure that we open windows especially at home and public transport - even in winter. These same interventions will also work to limit both the spread of Coronavirus and Tuberculosis.
Hon Chairperson, I thought that with all the panic around Coronavirus - which is understandable because it is a novel disease - I should point to the similarities between this old disease which we are talking about today which is Tuberculosis and the new one which is only a few months discovered, that's Covid-19. Returning to TB, hon Chair, South Africa is one of the 22 highest burden TB countries in the world. In our country it's estimated that about 700 people in every 100 000 have TB. We estimate that more than 320 000 people contract TB
every year - so in fact we have to worry as much, if not more about TB than other diseases. As we have said many times - for as long as one is breathing one can get TB because it is an airborne disease.
As hon members know - TB and HIV are two sides of the same coin. About 60% of people living with HIV also contract TB because HIV as we know weakens the immune system. In fact, most people with HIV who die - die because of the result of TB. Therefore, it is very important for us to deal with these diseases together.
According to Statistics SA in 2016 using the death notification reports, there were 29 513 deaths as a result of TB out of the total death which were over 450 000, that's 6,5% of the deaths reported in 2016 were related to TB. This is lower than the number of deaths due to TB in two years before which was 2014 which was 39 000. In other words, in 2014 we were 10 000 more deaths from TB which constituted 8,3% compared to 2016. So, the number is going down but is still very high. The good news is that as I said earlier, TB is curable. We have world class diagnostic tools - called GeneXpert - and drugs in South Africa and these are free in
the public health facilities. Our health workers are well trained to diagnose and treat TB. We even have drugs such as isoniazid preventive therapy, in short called IPT to prevent - especially focussing on people living with HIV - from contracting Tuberculosis.
South Africa is a world leader in several areas when it comes to TB. We have top class TB researchers; we were the first country in the world to expand the Genexpert platform to all our laboratories and used our volume of tests to reduce the global costs of this Genexpert; we were the first to use a drug called bedaquiline to treat multiple drug resistant TB and again because of our volumes, we were able to drive the cost of this drug down from a high of US$800 per patient to half of that which is US$400; and we also have the largest number of patients on the IPT, which is the prophylaxis which I mentioned earlier
Despite these achievements, we have many challenges. We should be finding and treating around 320 000 people as I mentioned the infection rate each year. However, at the current moment, we are only able to trace 220 000, which means almost a 100 000 people we are not able to trace. They are unknowingly
spreading the disease. Especially men are missing in terms of coming to the clinics and therefore be tested. We are missing men and young people largely because men and young people do not typically visit our health facilities.
For a number of reasons South Africa also has many patients who are drug resistant or also extremely drug resistant. We used to think that only those who didn't complete their treatment become resistant to the first line of TB treatment but now we know that what is worrying is that the drug resistant form of TB can also be transmitted from one person to the other. If one person has developed a drug resistant, they can infect the next person with the kind of TB which is resistant to the first line of treatment.
This means that we must do everything possible to stop the transmission, which means we need to focus on prevention, early diagnosis and treatment for six months if is the drug sensitive TB with the fist line. But once you go into the resistant mode of TB then you require nine months to 12 months.
There are a number of interventions to increase our ability for case finding, in other words to find people who are not diagnosed and we are implementing these in our facilities.
However, I wish to encourage hon members - especially as we relaunch this Parliament TB Caucus to spread the message that: Firstly, people with symptoms of TB must get tested and treated as soon as possible - don't wait until the symptoms become unbearable; Secondly, once the diagnosed take the prescribed treatment and ensure that the course of medicines is completed - if not, you will run the risk of spreading the disease.
So, hon members, as I conclude, I want to say to you that indeed TB can be defeated if we work together. Thank you very much. [Time expired.] [Applause.]