DURBAN - South African health workers should become more afraid
of tuberculosis (TB) and the impact it is having on health
resources and people living with HIV, infectious diseases expert
Professor Anton Stoltz has told the opening session of the
country's first TB conference.
Addressing the more than 1 700 delegates, Stoltz - who heads up
the Foundation for Professional Development's Infectious Diseases
unit - said South Africa was spending huge amounts of money on
its TB Control Programme with 70% of the budget going to
multi-drug resistant (MDR) and extensively-drug resistant (XDR)
Around 20% of the budget was dedicated to the Directly Observed
Treatment Short-course Strategy (DOTS) which is aimed at ensuring
that people with TB complete their treatment, reducing the
chances of developing MDR TB.
It costs around R377 to treat TB, after which the patient is
cured, compared to around R50 000 to cure MDR TB, if the patient
"Prevention of MDR is critical in South Africa," said Stoltz.
Referring to the need for infection control in health facilities,
Stoltz said his impression was that "we are not afraid enough of
"We need to protect ourselves against this disease," he stressed.
Another factor contributing to the high costs of treating TB was
the difficulty to diagnose it in people infected with HIV, Stoltz
"We struggle to find TB in people with HIV and it is expensive to
find," he said.
South Africa's cure rate stands at about 57% and Stoltz this
would have to be improved dramatically if the country wanted to
make any meaningful impact on the epidemic.
Three priorities identified by Stoltz included increasing the TB
cure rate, rethinking the DOTS strategy and increasing infection
Chair of the conference and former head of TB control in the
health department, Dr Refiloe Matji said for too long
stakeholders have been working in silos with the impact on the TB
"We need to build one team, follow-up with one plan, towards one
goal," said Matji.
Health minister Dr Manto Tshabalala-Msimang faced a silent
protest by a small group of Treatment Action Campaign members at
the start of her opening address. Brandishing posters, the
activists called for leadership and respect for the scientific
governance of medicines.
The minister acknowledged that TB would have to be addressed if
the country hoped to reach the Millennium Development Goals.
At an earlier press briefing the minister committed her
department to making the new test for MDR-TB available within the
next few months.
The new World Health Organisation approved test will enable
laboratories to diagnose MDR TB within a day and not the two to
three months as was the case previously.