Hon Chairperson, we have heard here today that Tuberculosis, TB, is a leading reported cause of death which is 88.4% of all deaths in South Africa and the leading cause of death by a single infectious agent globally.
The ANC led government has been at the forefront of working towards and ensuring improved outcomes for all South Africans with regard to tuberculosis infection.
We are also the leaders in the world with respect to this and I'm going to showcase it here that we are those leaders. In 2006-2016 the number of deaths due to TB declined from 76 000 to 29 000, in other words more than half from 13% to 6%.
In terms of new cases, South Africa had 322 000 new TB cases in 2017 and 301 000 new TB cases in 2018, showing a significant decline. We understand that an estimated 63 000 people died from TB in 2018 and millions more South Africans have dormant or latent Tb. It is important to note this one.
Two thirds of those who died of the 63 000 were HIV-positive. There has been a change in the profile of people dying from TB with a decreasing proportion of children under the age of 15 years, a decrease in the number of adults over reproductive years which is 15-49 years of age and a decrease in the number of women.
The total reduction in TB incidents between 2015 and 2018 was 6.3% although in South Africa we are falling short of the End TB Strategy milestone of a 20% reduction, we have done fairly well to get the 6.3%.
South Africa's public sector provides diagnostic and treatment services for TB with no out of pocket cost, that's very important to note.
It is also important to note that 82% of drug susceptible patients, 55% of Multi-drug-resistant tuberculosis, MDR, patients and 48% Extensively-drug- resistant, XDR, patients are successfully treated.
We know that there is a link between Tuberculosis and HIV and that they are strongly linked and we must please note the following, that people with healthy immune systems may not fall ill from latent TB but people living with HIV a with a low CD4 count are much susceptible to active TB. The number of people with HIV-TB who died during treatment in 2017 was 11%, almost three times higher than the number of people who died on treatment for TB alone which was at 4%.
This decline in TB incidents in South Africa over the past decade is attributed largely to the broad roll out of antiretroviral therapy which is a huge achievement of the ANC led government.
Yes, the progress to ending TB is slow and gaps do exist in prevention diagnosis in treatment of TB and therefore early detection and early effective treatment are essential to preventing TB associated deaths.
The emergence of MDR-TB and XDR-TB created quite a challenge in terms of numbers, 15 986 MDR-TB cases and 747 XDR-TB cases were reported in 2017 and 11 000 fell ill with MDR-TB in South Africa in 20218.
The importance of these numbers is the following that those patients have fewer treatment options with longer treatment durations, more severe treatment side effects and lower treatment success and survival rates. The standard treatment for MDR-TB was only effective in 50% of cases and that injectable had serious toxic side effects.
South Africa is the first country in the world to take the bold step to ensure that no one with drug resistant TB was denied access to better drugs by scaling up access to a new effective drug making MDR-TB treatment more tolerable.
Experience with this drug called bedaquiline in treating drug resistant TB made mainly from South Africa with experience from South Africa demonstrates improved clinical outcomes in people living with MDR-TB that is safer and effective.
So, this progressive move by the National Department of Health of the ANC led government to introduce the bedaquiline for all patients is a historic achievement.
Now, health facilities and primary health care must be supported in developing capacity to use bedaquiline and other new drugs and to access new and repurpose drugs asteriated in Drug-resistant, DR-TB, regiments must be improved in order to ensure treatment initiation and access to drugs and patient support closer to the communities where DR-TB patients live.
In addition, the National Department of Health, NDOH, is hoping to introduce 3HP, which is the once weekly treatment for 12 weeks for latent TB in four districts very soon and is also happy with the results to date with the new drug combination BPaL, which is being trialled in South Africa, which is a three-drug combination currently showing a 90% treatment success rate.
Additionally, South Africa has spear headed the new important health technologies in terms of tuberculosis. It's one of the first countries to implement the gene expert TB diagnostic following recommendations by the World Health Organisation.
Gene experts significantly reduce the turn around times for diagnosing both drugs susceptible TB and Rifampicin resistant TB.
In addition to pioneering new health technology, South Africa has demonstrated a significant political will and leadership in pushing for global action and investment to address TB.
South Africa committed more to TB Research and Development as a percentage of Gross Domestic Product, GDP, than any other country, making South Africa the largest funder of TB Research and Development as a percentage of government expenditure.
On the TB research front, South Africa substantial clinical trial capacity and trials of TB drugs and TB vaccines received significant funding from foreign donors as well as from our South African government.
Significant basic TB research is conducted in our country particularly in relation to identifying better diagnostic and prognostic bio-markers or sets of bio-markers.
So, work on TB diagnostics in South Africa has led to three diagnostic products being spun off into companies, with one diagnostic product used to collaborate gene expert machines already in wide use.
To speak to the hon members who mentioned here what they can be doing for us, we are the leaders in the world in terms of TB.
To the hon member of the EFF, I cannot see how you can assist us in dealing with TB if we are the world leaders and I have just showcased this to you here.
To hon Wilson and Ismail, I need to reiterate what hon Gillion had said as a medical person and having trained here in the Western Cape, Western Cape was the hub of TB, it was and still is the hub of TB and I find it strange that you will say that you will be able to show us how to treat TB.
The ANC led government is very active in the fight against tuberculosis. In prevention, treatment, use of new drugs, improvement of the co-mobilities like HIV, diagnostics and technology, research and development led by our President
Cyril Ramaphosa as the only head of state from a Brazil, Russia, India, China and South Africa, BRICS, country to attend the 2018 United Nation, UN, high level meeting on TB during which he called for greater TB Research and Development investment, affordable drugs and the adoption of intellectual property laws that promote public health. Thank you Chairperson.