By Petronella Sibeene
WINDHOEK
Namibia has the worst tuberculosis record in the world with over 15 000 cases being reported last year alone.
The four regions heavily burdened with TB are Erongo, Hardap, Karas and Oshikoto, all reporting notification rates of 1 000 and above TB cases for every 100 000 people.
Minister of Health and Social Services, Dr Richard Kamwi, disclosed these shocking statistics last Friday when Namibia joined the rest of the world in commemorating World TB Day. The day was commemorated worldwide last Friday.
“Last year, Namibia reported in absolute numbers 15 771 TB cases which translated into 765 TB cases per 100 000 population. This indicates that although the actual numbers of cases seem small when compared to the population of Namibia, we are indeed a country with the worst recorded TB rate in the world,” Kamwi revealed.
Describing Namibia as being in a very serious situation, WHO experts report that the country is only successfully treating 75 percent of the cases compared to the national target of 85 percent. Even if the country has failed to reach its target, Kamwi acknowledges the increase of five percent in cases of successful treatment.
The health sector has also achieved a reduction in the number of deaths to seven percent and those defaulting on medication from 13 to 10 percent.
The 2006 World Health Report indicates that Namibia detects 88 percent of TB infections against a target of 70 percent. The minister urged health workers to redouble their efforts in order to detect the entire 100 percent of the population.
He encouraged all TB sufferers to make sure they complete their treatment.
TB is contagious and one of the common diseases that lead to death. The disease is very difficult to control under circumstances associated with poverty. With the vicious cycle of poverty and disease prevailing in Namibia, it becomes imperative that each and everyone person plays an active role in controlling the disease, Kamwi said.
TB is transmitted through the air and thus spreads very easily, especially in enclosed and poorly ventilated dwellings.
Government recently allocated N$1.68 billion to the Ministry of Health and according to Kamwi, these funds are specifically for TB medications and tests besides other obligations of providing the required human resources, the infrastructure and the transport for control of TB that are equally financially demanding.
Despite Government putting TB control high on the agenda, Kamwi feels there is a requirement for building partnerships to complement government intervention efforts.
So far, the United States of America International Development (USAID) as a bilateral development partner is investing more resources in TB control and has increased support from US$1.2 million to US$2 million for the 2007 financial year. Equally, the World Health Organisation (WHO) continues to give Namibia valuable technical support.
According to Kamwi, the fight against TB would not be won if equal strong partnerships were not built at the community levels.
“Where there are strong partnerships, and close collaboration towards overcoming implementation bottlenecks, and ensuring that resources reach where they are needed most, experience has shown that development goals can indeed be achieved,” Kamwi added.
Although the TB burden is aggravated by HIV/AIDS, the minister emphasised that a person can be TB-positive yet HIV-negative. It is also true that a person living with HIV/AIDS is likely to be infected with TB due to a weak immune system, he said.
The prevalence of TB disease in persons infected with HIV/AIDS is estimated to be at 50-60%, the 2005 official statistics show.
Kamwi encouraged all TB patients to know their HIV status in order to benefit from life prolonging treatment together with anti-retroviral treatment in the event they are found to be HIV-positive.
He reiterated that TB is curable even in people living with HIV/Aids (PLWHA).
“We are also encouraging those on treatment to complete their course of treatment successfully. This approach is called ‘COMBI’ which stands for Communication for Behavioural Impact.”
The ministry has so far developed a fully costed 1st TB Medium Term Plan for 2004-2009 to guide the process of implementation and resource mobilisation.
The ministry is in the process of increasing public awareness using newer strategies that will result in behavioural change in seeking early assistance by individuals with possible TB infection or illness.
In 2005, the ministry launched the TB strategic plan MTP1 followed by the launch of the revised TB guidelines and the introduction of Fixed Dose Combined (FDC) TB tablets – interventions to reduce the burden of TB in Namibia.
Currently, the ministry is providing districts with the necessary tools needed to facilitate and strengthen implementation of TB/HIV interventions, the minister said.
Through the support of the Global Fund in the Fight against HIV/AIDS, TB and Malaria (GFTAM) and Centres for Disease Control (CDC), the ministry has managed to secure funding to procure 53 vehicles.
These vehicles are expected to assist in delivering essential TB/HIV services including conducting outreach to and follow-ups of TB/HIV patients, tracing defaulters and conducting supervision and in-service training.
World TB Day this year was commemorated under the theme, “TB Anywhere is TB Everywhere”.