Address by Deputy President David Mabuza on the occasion of South Africa's World TB Day Commemoration, Mpumalanga Province

Minister of Health, Dr Zweli Mkhize, 
Premier of Mpumalanga Province, Ms Refilwe Mtshweni-Tsipane
Deputy Ministers,
Mayors in attendance, 
Deputy Chairperson of SANAC, Ms Steve Letsike,
CEO of the SANAC Trust, Dr Thembisile Xulu,
Representative of the World Health Organisation, Dr Owen Kaluwa, 
Representative of the US Mission to South Africa, Mr Todd Haskell,
Representatives from business, labour, and broader civil society,  
Co-Programme Directors, MEC for Health Ms Sasekani Manzini and SANAC Civil Society Forum Deputy Chairperson, Mr Solly Nduku, 
Ladies and Gentlemen,

Today’s commemoration of World TB Day is like no other in the recent past. Globally, almost all nations of the world are engulfed by the anguish and hardship of Covid-19 which continues to obliterate lives and livelihoods on an unprecedented scale. The whole world is grappling to adapt to the ravaging impact of the Covid-19 pandemic to ensure that we contain the spread of the disease and rebuild economies decimated by the disruption of trade and global supply chains.

Over the past year, governments have had to respond to the overwhelming demands of Covid-19 on national health systems. The capacity, efficiency, and effectiveness of national health systems continue to be strained by waves of infections, hospitalisations, and deaths.

To some extent, national lockdown and restrictions of movement contributed to the disruption of access to health services and the reduction in the number of TB detections as patient contact and tracing services became difficult during lockdown periods. 

As a global community of nations, we are commemorating World TB Day fully aware, and alive to the threats and negative impacts of Covid-19 on the fight against TB. This pandemic has the capacity to erode the achievements and progress achieved to date in the fight against the spread of TB.

The potential diversion of priority focus and financial resources away from TB programmes to fund the responses to the Covid-19 pandemic pose serious risks to the consolidation of global efforts to end TB. The deepening levels of poverty, malnutrition and unequal access to TB treatment and care may undermine efforts to meet global targets to end TB.  

Today, we are reminded, as citizens of the world, that we have to act with a sense of urgency in pursuit of TB targets advocated in the Sustainable Development Goals, the World Health Organisation End TB Strategy, and the 2018 Political Declaration of the UN Meeting on TB.

While challenges of Covid-19 will persist in the foreseeable future, we are encouraged by progress made in the fight against TB. According to the World Health Organisation’s 2020 Global TB Report, the number of people treated for TB has grown since the 2018 UN high level meeting, with over 14 million people reached with TB care in 2018 and 2019. The number of people provided with TB preventive treatment has quadrupled since 2015, from 1 million in 2015 to over 4 million in 2019. 

We need to consolidate and build on these achievements to enhance equitable access to quality and timely diagnosis, prevention, treatment and care.

As one of the 30 countries with a high burden of TB, we are joining the world to galvanise our own society to realise that “The Clock is Ticking: Let’s Find, Treat, and End TB Now”. It is a theme that resonates well with the call for global solidarity and collaboration in the fight against TB. Time is of the essence. There is no room for complacency.

We are calling on all South Africans to rally behind national efforts to end TB and scale up our national response through urgently finding, initiating and retaining TB clients in treatment and care. We should also work hard to regain those who have fallen by the wayside. Each and every one of us has a role to play in the fight to end TB. 

Our National Strategic Plan on HIV, TB and STIs that was launched in 2017 remains our guiding implementation blue-print that enables multi-stakeholder participation and collaboration in the fight against HIV, TB and STIs.

In terms of this plan, we had targeted to diagnose at least 90% of all people infected with TB. We had also committed to treating 100 percent of those who have tested positive, and decrease TB deaths by at least 30 percent. 

This year, the National Strategic Plan is nearing the finish line, yet the numbers in terms of targets we had set for HIV, TB and STIs, remain stubbornly high. We set for ourselves the target to reduce new TB infections from 450 000 to 315 000 per year. 

Data from the recent TB Prevalence Survey, indicates that 390 000 people became infected with the virus in 2018, just a year after the launch of this National Strategic Plan. 

Out of the estimated 390 000 people infected with TB, only 60% of them were diagnosed. This suggests that there is a large number of people who are walking around with the infection but are not on treatment. That is dangerous considering that one person infected with TB could potentially infect a further 15 people. 

The survey also revealed that we had underestimated the prevalence of asymptomatic TB. Nearly 60% of people who tested positive for TB did not display any of the classic symptoms. This means we need to refine our case detection approach. To achieve this, we must work together as communities and health facilities. 

SANAC remains central to all our national efforts of mobilising various sectors of society to ensure that we curb the spread of TB and eliminate infections. Working with all social partners, community formations, and community leaders, government is committed to urgently finding, initiating and retaining TB patients in the treatment and care. 

Through our ‘Cheka Impilo’ campaign we should ensure that everyone has the opportunity to regularly screen and test for TB at the nearest clinic so that they are initiated on treatment when they test positive. We are employing digital tools and platforms to raise community awareness and integrate TB and Covid-19 screening services. 

A TB HealthCheck mobile application that allows individuals to screen for TB risk and symptoms in order to reduce transmissions, has been recently launched. This mobile application is designed to make self-screening easy and efficient, while also identifying individuals who need to get tested. It refers those who require a test to public health facilities for a free TB test. The system is integrated into HealthCheck, which is the Department of Health’s Covid-19 digital self-assessment tool. 

More importantly, our TB response also prioritises communities in Districts with the high TB burden to ensure that we contain the spread of infections and turn the situation around. For instance, Ehlanzeni District, our host for this year’s commemoration, is among the Districts with the high TB burden in South Africa and has been one of the hardest hit areas by the disease. We are all here today to underscore the importance and urgency of the need to work with communities and all social partners in this District to ensure that we eliminate the spread of TB and save lives. 

SANAC will continue to work with provincial and local structures to drive specific interventions in line with the goals and targets of the National Strategic Plan on HIV, TB and STIs.

SANAC has prioritised a number of interventions focusing on mobilising targeted sectors of society in response to prevalence survey reports and trends. One of these interventions focuses on men’s behavioural change. 

According to the results of the latest TB prevalence survey report, TB prevalance is 1.6 times higher in men compared to women. 

In this regard, the SANAC Men’s Sector has done commendable work through various platforms in an effort to sensitise men about the importance of fostering health seeking behaviour. Until we reach and change men’s perspective in every setting, we will never win the battle against TB. 

We therefore call on all men across the country to be counted in the nation’s efforts to end TB. Unless men heed this call, the well-being of South Africans will forever lie in the balance. Men must be encouraged to test for TB so that they get treated early before they spread the disease within their families and the entire community.

Notwithstanding challenges that we are dealing with, we are happy that we have set up strong collaborative platforms with our communities as well as our local and international partners.

We would like to take this opportunity to thank all our international and local partners who have made contributions to making our HIV, TB and STI programmes a success. We are grateful to work together with our global partners and donors, including the United States President’s Emergency Plan for AIDS Response and the United Nations Global Fund for AIDS, Tuberculosis and Malaria.

We would also like to thank our local private sector partners who have made contributions to the implementation of our HIV, TB and STI programmes.

We need continue to mobilise additional resources to fund our programmes and broaden our footprint to cover more areas in the course of rolling out TB prevention programmes.

To advance policy reforms that prioritise TB, we will continue to enjoin the contribution of all public representatives and leaders such as parliamentarians, legislators, traditional leaders, and health care workers.

We are pleased with progress made by the South African TB Caucus Secretariat, in their efforts of establishing TB Caucuses in all provinces of the country. The TB Caucus is a non-partisan country structure that forms part of the Global TB Caucus, an international network up of over 2500 parliamentarians from over 150 countries across the globe who work collectively and individually, across geographical divides and by engaging with civil society and other stakeholders towards ending the TB epidemic.

This work is important in enabling legislators to advocate for the financial resources towards the TB response and marshal policy reforms that enable the effective roll-out of TB prevention programmes.

Across the world, we need foster and deepen multilateral platforms of collaboration in the fight against TB, Covid-19 and many other disease outbreaks that threaten human lives and the catastrophic collapse of the global economy. At the heart of this is the genuine desire to eliminate poverty, social disparities and inequalities in order enhance economic inclusion and shared prosperity. The poor and vulnerable sectors of our must access universal health coverage so that they improve the quality of their lives.

A human rights approach must always define the nature of global solidarity and cooperation so that we build a better world, free from poverty and the burden of disease

Thank you.