UN Swaziland - Resident Agencies \| World Health Organisation (WHO)

World Health Organisation (WHO)

Swaziland Declares TB Emergency

The Government has declared TB as a national emergency as it intensifies the fight not only against the ancient disease of TB but also against the now well established link between TB and HIV.
Announcing the emergency, the Prime Minster Dr. Sibusiso Dlamini underlined the declaration as an important signal to potential donors for technical and financial assistance. He applauded the Global Fund which had already allocated a grant of US$40 million to support the implementation of the TB and TB/HIV Emergency Response Plan for intensified action at community level. He also noted that the declaration calls attention and reminded the country of other various international declarations and Resolutions on the TB particularly the 2006 recommendation of SADC countries on the emergence of the XDRD and MDR strains of TB and the need for urgent action.
Speaking at the same event, WHO country representative Dr Owen Kaluwa, the WHO Country Representative acknowledged the actions taken by Swaziland  to control TB particularly embracing the Stop TB Strategy and by making significant progress in expanding access to high quality TB diagnosis, treatment and care for an increasing proportion of the population.
This, Dr Kaluwa observed, demonstrated high levels of political commitment in addressing the TB, TB/HIV and MDR-TB epidemic. He aptly noted that the theme for the World TB Day 2011 “On the move against tuberculosis, transforming the fight towards elimination” also reiterates the need to step up efforts in the fight against TB with the ultimate goal of its total elimination.
The current status of TB in the country is indeed dire as tuberculosis remains a major public health problem in Swaziland. The country is not only having the highest TB incidence in the world (1198 per 100,000 population), but also one of the highest TB/HIV co-infection rates where 80% of incident TB cases are already HIV positive. TB kills an estimated 2,780 people in Swaziland annually mostly within the most productive age group. Preliminary results of a country wide drug susceptibility testing survey shows that the prevalence of MDR TB among the new cases is 7.7% and 33% among previously treated cases (DRS 2009).
The National Tuberculosis Control Program (NCTP) has implemented the Directly Observed Treatment Short Course (DOTS). However, these efforts have been frustrated by the effects of HIV&AIDS, limited service outlets with adequate equipment and human resources, and the situation of Multidrug resistant TB (MDR-TB) and Extensively Drug Resistant TB (XDR-TB).
WHO established a position for Medical Officer-TUB in 2008 to ensure consistent technical support to the Ministry of Health through the national TB programme to effectively implement the Stop TB Strategy. The support focuses resuscitation of quality DOTS implementation; addressing TB/HIV and multi-drug resistant TB in the country.
Urgent technical assistance that was needed by the country to immediately address the TB and TB HIV dire situation included the following:
Enhanced prevention, treatment and care of HIV/AIDS, TB
Scale up of high quality integrated HIV/AIDS, TB and malaria prevention, treatment care and support provided to national programme
Improved prevention and treatment of HIV, TB, MDR-TB and TB/HIV through development of progarmmes that promote equitable access to essential medicines and their rational use by prescribers.
Improved monitoring and evaluation of programe including the evolution of drug resistance for HIV/AIDS, TB and malaria through strategic information systems;
Sustained political commitment, resource mobilization and partnership to fight HIV/AIDS, malaria and TB at national, and district levels through advocacy, communication and social mobilization (ACSM);
Increased new knowledge, intervention tools and strategies from operational research by national institutions and experts to better prevent and control HIV and tuberculosis. The treatment results of the latest cohort of 2,879 TB patients registered for treatment in 2007, indicate a significant improvement in the treatment success rate as 58% (1,671) of were successfully treated. This falls short of the Global target of 85% treatment success rate. High default rate of 11%, transfer rate of 10%, death rate (7%) and 8% not evaluated are the main unfavorable outcomes affecting the treatment success rate.
Efforts must be intensified to ensure adequate follow up of all patients with the view to having them evaluated at the endp

WHO             Contact details
WHO Swaziland Country Office
P. O. Box 903 MBABANE
Tel: (+268) 404-2928
Fax: (+268) 404-4566
Physical Add: 2nd Floor Lilunga House, Somhlolo Road, Mbabane

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