‘TB virus resistant to current treatment’
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File photo: Dr Gwen Ramokgopa. Picture: Sjenade Williams File photo: Dr Gwen Ramokgopa. Picture: Sjenade Williams
Durban - Tuberculosis is laughing at the country’s current generation of citizens, says Deputy Health Minister Gwen Ramokgopa.
That is not only because the virus has outlived so many South Africans, but it has also outsmarted age-old technology developed to fight it.
Ramokgopa made these remarks at the sixth South African Aids Conference in Durban on Wednesday after co-chairing a plenary session which addressed, among other topics, the issue of advancement in TB vaccination.
“TB has also found comfort in its trusted partner, HIV and Aids, and we do not seem to be responding adequately to that,” she said, adding that it was imperative to build on the successes already achieved in the fight against the virus, and to invest more resources in it.
Ramokgopa was speaking after presentations by Professor Willem Hanekom, the director of the South African Tuberculosis Vaccine Initiative at UCT, and Dr William Bishai, of the KwaZulu-Natal Research Institute for Tuberculosis and HIV.
While Hanekom noted that the deputy minister had mentioned earlier at the conference that R2.5-billion was being invested in HIV and Aids vaccines over the next three years, he said only about R500 million was going towards TB.
“TB is the number one killer in South Africa and, yes, a lot of those who die from it also have HIV/Aids.
“Most countries with high TB burdens have seen a drop in the rate of TB over recent years, but South Africa has not,” he said.
Citing some recent studies, Bishai showed that, over the past 50 years, scientists had discovered that not only were the incorrect dosages of TB treatments often administered to patients, but that some treatment combinations were weakening the treatment.
He said after 50 years, new TB drug classes were only finally emerging and that there was “new hope” for multi- and extreme drug-resistant TB (M/XDR-TB), which was particularly problematic in KZN.
Dr Francesca Conradie, the president of the South African HIV Clinicians Society, said the stigma attached to TB was often worse than that of HIV and Aids.
“There are problems in the way we have dealt with TB in the past which has lead us to where we are now, with an infection rate of one percent… We also use stigmatising language when talking about TB,” she said, citing as examples the words “TB control” instead of treatment, “suspect” when someone might have the virus, and “defaulter” if they did not complete their medication courses.
“We use kinder words with HIV… and just like we do with HIV/Aids, we need to tell TB patients how important their medication is, what happens if they do not take it, and the medication’s side-effects.”
She said both HIV and Aids and TB were conditions that “we, as a health-care society”, had stigmatised.
The conference also heard that the upscaling of antiretroviral treatment nationally had had a clear impact on mortality rates of adults infected with HIV and Aids in Hlabisa, KwaZulu-Natal.
Portia Chipo Mutevedzi, of the African Centre for Health and Population studies at the University of KwaZulu-Natal, said the recent conclusion of an eight-year study in Hlabisa – which treated patients with elevated levels of CD4+ cell counts up to below 350 – said there was “strong evidence” of a shift towards early initiation of antiretroviral treatment, with fewer adults initiating treatment at a very late stage.
There was also a reduction in early mortality rates – defined as death within 91 days of beginning treatment – from August 2011 to July 2012. - The Mercury