UN Swaziland - Resident Agencies \| World Health Organisation (WHO)
Swaziland Declares TB Emergency
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 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
Providing leadership in the world health agenda
WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends.
In the 21st century, health is a shared responsibility, involving equitable access to essential care and collective defence against transnational threats.
The WHO agenda
WHO operates in an increasingly complex and rapidly changing landscape. The boundaries of public health action have become blurred, extending into other sectors that influence health opportunities and outcomes. WHO responds to these challenges using a six-point agenda. The six points address two health objectives, two strategic needs, and two operational approaches. The overall performance of WHO will be measured by the impact of its work on women's health and health in Africa.
1. Promoting development During the past decade, health has achieved unprecedented prominence as a key driver of socioeconomic progress, and more resources than ever are being invested in health. Yet poverty continues to contribute to poor health, and poor health anchors large populations in poverty. Health development is directed by the ethical principle of equity: Access to life-saving or health-promoting interventions should not be denied for unfair reasons, including those with economic or social roots. Commitment to this principle ensures that WHO activities aimed at health development give priority to health outcomes in poor, disadvantaged or vulnerable groups. Attainment of the health-related Millennium Development Goals, preventing and treating chronic diseases and addressing the neglected tropical diseases are the cornerstones of the health and development agenda.
2. Fostering health security Shared vulnerability to health security threats demands collective action. One of the greatest threats to international health security arises from outbreaks of emerging and epidemic-prone diseases. Such outbreaks are occurring in increasing numbers, fuelled by such factors as rapid urbanization, environmental mismanagement, the way food is produced and traded, and the way antibiotics are used and misused. The world's ability to defend itself collectively against outbreaks has been strengthened since June 2007, when the revised International Health Regulations came into force.
3. Strengthening health systems For health improvement to operate as a poverty-reduction strategy, health services must reach poor and underserved populations. Health systems in many parts of the world are unable to do so, making the strengthening of health systems a high priority for WHO. Areas being addressed include the provision of adequate numbers of appropriately trained staff, sufficient financing, suitable systems for collecting vital statistics, and access to appropriate technology including essential drugs.
4. Harnessing research, information and evidence Evidence provides the foundation for setting priorities, defining strategies, and measuring results. WHO generates authoritative health information, in consultation with leading experts, to set norms and standards, articulate evidence-based policy options and monitor the evolving global heath situation.
5. Enhancing partnerships WHO carries out its work with the support and collaboration of many partners, including UN agencies and other international organizations, donors, civil society and the private sector. WHO uses the strategic power of evidence to encourage partners implementing programmes within countries to align their activities with best technical guidelines and practices, as well as with the priorities established by countries.
6. Improving performance WHO participates in ongoing reforms aimed at improving its efficiency and effectiveness, both at the international level and within countries. WHO aims to ensure that its strongest asset - its staff - works in an environment that is motivating and rewarding. WHO plans its budget and activities through results-based management, with clear expected results to measure performance at country, regional and international levels.