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) TB.

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 survives.

"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 this disease".

"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 said.

"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 control.

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 epidemic fragmented.

"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.