Joint Statement for World TB Day

On this day last year the Western Cape Department of Health and an alliance of non-governmental organisations, signed an agreement in which all parties committed to partner to strengthen the fight against HIV and TB in this province.

Theuns Botha, Western Cape Minister of Health, reviewed the progress made. "Significant strides have been made, but to me it is evident that the stipends for community care workers need to be reviewed. Community care workers and TB treatment supporters form an essential part of the success rate for total recovery, but the financial compensation is not satisfactory. I have requested my department to make recommendations in this regard."

Minister Botha also pointed out that case detection remains a focus area. "Intensified TB case finding is a key priority for the coming year." According to Prof. Harry Hausler, Director of TB/HIV Care Association, "Progress has been made but there is a need for more intensified engagement with communities to ensure that TB and HIV are controlled in the Western Cape. The time is now for community care workers including TB treatment supporters to receive better pay in recognition of the contribution that they make to deliver health services in their communities". TB/HIV Care Association is a non-governmental organisation that is committed to working in partnership with government to help prevent, find and treat TB and HIV.

The Western Cape Department of Health's campaign is underway in all 32 sub-districts of the province, and focuses on:

• Intensified TB case finding using the HCT Campaign as a vehicle for detecting more TB cases at health facilities as well as in the community
• Follow-up and tracing of TB contacts and defaulters

The campaign uses a two-pronged approach by engaging and capacitating communities to increase their knowledge of TB and HIV and motivating communities to take responsibility for their own health by testing for HIV, being screened for TB and being tested for TB if symptomatic. Anyone with cough, fever, night sweats or weight loss should go to the clinic to have a test for TB.

An important part of the process is the motivation of facility staff to find high quality TB services. This means it is important to detect and treat active TB cases early and ensure that they adhere to drug treatment as easily as possible until cured.

Progress since last year's World TB Day on key issues is outlined below:

1. The Western Cape Department of Health has resolved that the Provincial AIDS Council will also be responsible for leading the multi-sectoral response to TB.
2. The provincial Department of Health has prioritised ART roll out in TB facilities first, and to provide integrated TB/HIV services in clinics and communities. From April 2010 to January 2011 the Western Cape have tested 593 382 people and screened 510 602 for TB and referred TB suspects to health facilities for TB testing. The TB/HIV Care Association has contributed to the HCT campaign through its 6 mobile HCT teams in the Western Cape.
3. Isoniazid preventive therapy decreases the risk of developing TB in asymptomatic people living with HIV by 60%. The provincial Department of Health is committed to ensuring that 40% of patients in HIV care and ART will be initiated on this drug by June 2011. The Western Cape has been at the forefront of decentralisation of MDRTB treatment, recently appointing an MDRTB nurse and MDRTB counsellor in each of the 8 sub-districts in Cape Town to strengthen the MDRTB programme and work in collaboration with NGOs.
4. Strengthen the link between facilities and communities through funded facility-based community team leaders to coordinate community care workers
5. The province has developed an integrated TB/ART adherence support plan for implementation in April 2011. As part of this plan, the Province will make proposals to standardise stipends for comprehensively trained community care workers that support TB and HIV clients.
6. The province is committed to performance based management of community based services, transparency and sharing of information. This means that NGOs that provide adherence support will be provided with health information on treatment outcomes of the TB and ART patients that they are supporting so that they can monitor the performance of their community care workers and ensure that the best quality care is provided.

Jointly issued by:
Theuns Botha
Western Cape Minister of Health

Media Enquiries:
Hélène Rossouw
Cell: 082 771 8834
E-mail: herossou@pgwc.gov.za

Prof Harry Hausler
Director of TB/HIV Care Association