Rudolf Gaiseb
Health executive director Ben Nangombe said despite government and donor efforts poured into fighting Tuberculosis (TB), the country’s dream of eliminating the disease is far from being achieved.
In a recent interview, Nangombe said the World Health Organisation (WHO) classifies Namibia as a high-TB burden country, based on the high concentration of people with TB, despite its small population.
“Namibia was ranked 11th globally on the incidence rate last year. Our TB cases peaked in the mid-2000s, but have been gradually declining since then. However, 25% of TB cases remain undiagnosed and hence untreated, and we are not yet close to eliminating TB at this point,” said the executive.
The health ministry, through the National Tuberculosis and Leprosy Programme funds over 80% of TB costs in Namibia, including testing, diagnosis, treatment, infrastructure and human resources, but these efforts are not enough, he said.
“The different programmes aimed at combating TB include vaccinating all babies at birth, giving preventive therapy to all those at risk (including people with HIV and close contacts of TB cases and those with immunosuppression), and infection prevention and control practices. Community health workers and other community-based structures contribute immensely to the support of patients and families to ensure successful treatment outcomes,” he said.
He added that early TB diagnosis and treatment is the most effective way to curb transmission.
“TB diagnosis is made free of charge to Namibians in the public health sector, and the current diagnostic technologies are used according to WHO standards. Active case-finding and screening activities are conducted for at-risk, key and vulnerable populations to find those with TB, and put them on treatment.
TB treatment is also provided free of charge with regimens that are recommended by the WHO,” he stated.
He said for the usual drug-susceptible TB, treatment is available at local clinics.
Anyone found to have TB can start treatment immediately.
He said for the more complicated drug-resistant TB, treatment is available at district hospitals.
“However, once a patient has been diagnosed with drug-resistant TB, treatment can be decentralised to the clinics,” he said.
According to the health ministry, the current incidence rate of TB, which is the number of TB cases estimated to occur per 100 000 populations per year, is 450/100 000 per year in Namibia.
The prevalence rate, which is the proportion of Namibians with TB at any given time per 100 000 based on a survey conducted five years ago, was 465/100 000.
In 2023, 9 200 drug-susceptible TB cases and 311 drug-resistant TB cases were recorded.
Nangombe said the effectiveness of the programmes can take a long time to show.
Treatment outcomes for TB are generally good, with a success rate of 87% for drug-susceptible TB and 75% for drug-resistant TB.
“While the overall incidence rate has been dropping over the years, owing to the various interventions, we are still expecting to find more cases of TB. The proportion of TB cases that we missed has been dropping from 46% in 2020 to 25% in 2023,” he said.
Public awareness and education are crucial in the process of addressing diseases such as TB.
“From a national-level point of view, currently, there is a lot of advocacy and information-sharing directly from the ministry through various organisations, through the Parliamentary Caucus on TB, and community health workers,” he stated.
He added that with aid from various non-governmental and international organisations that support TB programmes in Namibia, it is the government’s duty through the directorate of special programmes to develop policies and coordinate TB-related initiatives.
–rrgaiseb@gmail.com