Inter Press Service Examines TB Epidemic, Efforts To Fight Disease in Swaziland
The number of tuberculosis cases in Swaziland has increased from about 1,000 cases annually in 1987 to about 9,600 cases annually today, National TB Control Program Manager Themba Dlamini, said recently, Inter Press Service reports.
In addition, Swaziland has the highest HIV prevalence worldwide, Inter Press Service reports. "This escalation of TB cases can be attributed to the HIV/AIDS epidemic," Dlamini said, adding that 80% of people with TB in the country also are HIV-positive. Swaziland's TB detection rate is 57.7%, below the World Health Organization target of 70%, and the country's TB treatment success rate is 42%, compared with the WHO target of 85%. The increase in drug-resistant strains of the disease also is contributing to the situation, Dlamini said.
Dlamini said that efforts to declare TB a national emergency in Swaziland are underway. According to Inter Press Service, efforts to increase human resources, strengthen and decentralize TB services, and promote education about the disease likely will be scaled up if TB is declared a national emergency. "We needed to do serious lobbying to convince the Ministry of Health and Social Welfare and the National Disaster Management Agency that indeed TB is an emergency," Dlamini said. Swazi Deputy Prime Minister Themba Masuku in an address on World TB Day last month said that the Swazi government is "aware of the plans under way to declare TB as an emergency" and is supporting such efforts in line with the 2005 Maputo Declaration, which declared TB a continental emergency.
Health Minister Benedict Xaba said the health ministry is developing a contingency plan for declaring TB a national emergency that will need approval from NDMA and the
Cabinet and stressed that TB is a priority for the government. Dlamini added that the ministry is "convinced that TB is an emergency" but that the contingency "was not yet approved" when Masuku gave his address on World TB Day. Dlamini added, "For the first time, TB is the third priority after water and sanitation and HIV/AIDS" at the health ministry.
"Many patients are defaulting on treatment because they feel the TB treatment takes [too] long, and it gets worse when they are also taking antiretroviral drugs," Dlamini said, noting that food insecurity also is a "challenge." In addition, an increasing number of clinic nurses have contracted TB because of inadequate infection-control measures. "What's worse is that there are no clear policies on how government would assist nurses who get infected with TB at work," Bheki Mamba, president of the Swaziland Nurses Association, said. Mamba added that clinics also should post "safety precautions" so that TB patients understand "what is expected of them when they visit clinics and hospitals" to minimize the risk of transmitting the disease.
However, the global economic crisis could affect efforts to fight TB in the country, Inter Press Service reports. The Global Fund To Fight AIDS, Tuberculosis and Malaria recently called for a 10% reduction in a $5 million, two-year grant for Swaziland's TB program. Robina Mulenga, a World Food Program officer, added that the country was having difficulty securing foreign aid before the economic downturn began because of its status as a middle-income country. "Now we have to start looking for money within the country because Swaziland is not considered to be in a desperate need for aid," Mulenga said (Phakathi, Inter Press Service, 4/22).