An Africa without TB is possible

Lazarus Sauti

Tuberculosis, second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent, is making a serious comeback and cementing its position as a major public health concern.

“In 2013, 9 million people fell ill with TB, almost half a million of whom have a multi-drug resistant disease which is far harder to treat,” noted the World Health Organisation director-general, Dr Margaret Chan.

Dr Matshidiso Moeti, WHO regional director, says over 95 per cent of TB deaths occur in developing states, and countries in Africa remain with the uppermost tuberculosis deaths.

“(The) African region remains with the highest TB. Sadly, the poor are vulnerable and at most risk; especially homeless persons as well as individuals living in densely populated communities,” she said.

Countries in Africa must, therefore, take necessary steps to combat the disease, and effectively realise an Africa without tuberculosis.

Timur Abdullaev, a human rights expert, believes that to effectively address the tuberculosis blight, countries within and across the African continent must not ignore human rights issues.

“A tuberculosis response will only be effective when it is comprehensive and is based on human rights,” said Abdullaev, who is also a member of the Stop Tuberculosis Partnership Coordinating Board.

Dr Lucica Ditiu, the Executive Secretary of the Stop TB Partnership said: “It is unacceptable in the year 2015 to have people facing human rights abuse because of tuberculosis – forced treatment, detention, expulsion and social marginalisation.

“I feel responsible for not raising our voice loud enough in order to address the issues of tuberculosis and human rights at a different level.”

African leaders should, therefore, respect human rights issues if the continent is to eliminate tuberculosis.

Without doubt, cultural barriers are also triggering the comeback.

Consequently, political, business as well as traditional leaders must work together to ensure that socio-cultural barriers and stigma are effectively eliminated.

Further, they must work with women and provide them with access to high-quality care, free of catastrophic costs and social repercussions.

Dr Mario Raviglione, the Director of the WHO’s Global Tuberculosis Programme agrees, urging all involved in the work to end tuberculosis to commit to do much more to engage women in affected communities and, through them, enable equitable access to care.

“More than half a million women are dying of tuberculosis each year, largely because of poor access to health services as well as stigma and discrimination. This is something outrageous that we must correct urgently,” he said.

As highlighted by Dr Raviglione, most – if not all – African countries are still faced with structural gaps in health systems.

States need to close these gaps as a matter of urgency, and this, therefore, calls for solemn will and commitment from political leaders.

With the backing of political leaders, an Africa free of tuberculosis is feasible.  

The World Health Organisation added that an Africa without TB is possible, but only through a combination of early identification and treatment of the disease, preventive therapy as well as infection control activities.

To realise this, Nick Herbert, co-chairman of the All-Party Parliamentary Group on Tuberculosis, conversely, urged African governments to invest in research, development and strategic programmes that will lessen the burden of tuberculosis.

“We need better tools to deal with this new threat, but since TB primarily affects the poorest and most vulnerable in society, there is little commercial incentive to develop new drugs.

“For that reason, African governments must invest in research and development and target programmes that will effectively enable the continent to eliminate tuberculosis,” said Herbert.

The World Health Organisation concurs.

“Improving research and innovation in basic science, new diagnostics, drugs and vaccines and their rapid uptake, will be critical to break the trajectory of the epidemic and reach the global targets,” affirmed the WHO.

African countries need research so as to continue on the path to strengthen mechanisms that increase coverage and access to services for detection in addition to treatment of tuberculosis.

Since funding is also required, Dr Chan urged African countries to simply exploit their resources and increase investments in the fight against tuberculosis.

“Government sectors must intensify funding for the fight against TB as well as making care more accessible through financial protection schemes so as to minimise medical and non-medical costs as well as income loss,” she said.

Zimbabwe’s Minister of Health and Child Care, Dr David Parirenyatwa, also believes public and private sectors must support governments to intensify efforts to reach, treat, and cure everyone with tuberculosis.

“Partnerships between governments, public and private sectors are critical in the fight against TB. Public and private sectors must, thus, support governments to lessen their financial burden,” he asserted. 

Openly, an Africa without tuberculosis is possible, but only if African governments are committed to eliminate the disease by ensuring that their TB control programmes fully embrace the ‘End TB Strategy’ interventions.   

The strategy significantly addresses tuberculosis among vulnerable groups, including people living with HIV who develop TB.