By Frederick Philander
WINDHOEK
Namibia is one of the world’s worst HIV/Aids affected countries with a 19,9 percent prevalence rate last year, and also one of the highest rates of tuberculosis at 765 in every 100 000 people suffering from the illness.
American government senior HIV/Aids advisor, Peter Gichangi, said this during a USAID training workshop on management of Multi-drug Resistant Tuberculosis (MDR-TB) earlier this week.
USAID’s TB Control Assistance Project supported the training course through funding from both USAID as well as the United States President’s Emergency Plan for AIDS Relief.
“A few core doctors and staff have already received training in programme management of MDR-TB, but this is the first ever country level training for Namibia,” Gichangi said.
He urged the National TB Control Program to scale up its efforts to increase case identification and treatment success.
“I encourage you to be the people behind the statistics to decrease the number of patients that transfer out or default from their TB regimen,” he said.
MDR-TB treatment has been practiced in Namibian hospitals since 1999, using standard second line drug regimens sponsored by the government.
Gichangi however, said some alternative second line drugs are not available and basic systems were not in place to facilitate clinical management.
“This training should therefore not be considered the final solution to managing MDR in Namibia, but it is a critical step in the right direction,” he said.
According to him, the exact number of people suffering from MDR-TB in Namibia is not known.
“There is no routine surveillance and notification system in place. National level strategic guidance on MDR is provided in the National TB Control Strategic Plan (MTP-I), but this is not the same as having an MDR management action plan.
“No treatment outcomes are recorded for MDR, and unrestricted availability of second line drugs has led to widespread misuse,” he said.
He urged Namibians to understand how to improve clinical management of MDR, because health personnel’s help was needed to continue work with the National TB Control Program.
Their help was especially needed to put effective systems in place, linked to community mobilisation and advocacy efforts.
“With your help, it will not be long before we see stronger management of patients with MDR-TB in Namibia. The need for training in the management for MDR-TB is quite clear. We all know that in Namibia, we are plagued with a severe dual epidemic of both tuberculosis and HIV/AIDS.
“The HIV prevalence among TB patients was estimated to be 67% in 2006, and TB can be deadly for anyone with a compromised immune system. Worldwide TB is the number one cause of death for people living with HIV/AIDS,” he warned.
In his opinion, the United States Government has made a major commitment to tuberculosis treatment and control worldwide, and a major commitment to tuberculosis treatment and control in Namibia.
The US government has provided US$5 million since 2004 for TB Control and Prevention. In 2008, it planned to contribute US$3.5 million to support National TB Control Program efforts.
He felt Namibians had made a great deal of progress in the fight against tuberculosis.
“I applaud each one of those on the front lines in helping to confront the challenge of MDR. Only with your help can we effectively??????’??