MDR-TB a real threat in Swaziland

Alice Tembe, CNS Correspondent, Swaziland
Tuberculosis is taking the fast lane in Swaziland, and with approximately 1.3 million Swazis exposed to MDR-TB at first infection, it is increasingly becoming difficult to ignore it.  According to the WHO, of the nine million people who get sick every year with TB globally, one third of them are “missed" by health systems.

‘This situation is compounded by the harsh reality that the majority of these nine million people live in the world's poorest nations and are among the most marginalised populations such as migrant workers, refugees, prisoners, drug users, ethnic minorities and internally displaced persons’, noted a Times of Swaziland Guest writer on AIDS Lifeline sponsored by SAFAIDS.

President of the Swaziland Nurses Association, Mr Bheki Mamba was quoted by Phathizwe Chief Zulu saying that, “TB has increased threefold than what it was in the 1980s”. In this statement it is vital to note the double-pronged growth of TB prevalence and the complications arising with multi drug resistant TB (MDR-TB).

15 year old Colile Mavuso has had to abandon school to complete treatment for MDR-TB. She is however hopeful that she will resume school next year after completing treatment. Brimming with confidence, the young girl explains, “I will stay home until I finish the treatment because I have to be isolated lest I spread MDR-TB to other pupils".  Of note is the empowered and informed utterance from this young child with confidence that she will recover. This is the result of on-going awareness campaign anchored in the National TB Control Programme and the TB-HIV mainstreaming programmes through the multi sectoral interventions.

Swaziland is wary of the sustenance of TB programmes as donor funds continue to dwindle, including the Global Fund to fight AIDS, TB and Malaria. This may be detrimental and might reverse the gains of the TB interventions. Notably, more and more of Swaziland’s productive population are losing their jobs and families due to TB.

This year's World Tuberculosis Day commemoration event started off with a community march in Msunduza, a high density location in the capital city of Mbabane. This is one of the high risk communities due to poor housing infrastructure, dense population and meagre or no income. All these are factors that have been proven to increase vulnerability to spread of tuberculosis. The march led to Prince of Wales grounds, where several speakers, including the representative of the business community, Ms. Thobile Dlamini, CEO of the Swaziland Business Coalition on Health and AIDS (SWABCHA), voiced their sentiments. Ms Dlamini said that, “While national efforts to mainstream HIV and TB are just beginning, it is commendable that the private sector has been co-implementing the two programmes for the past five years”.

She explained that the workplace policy guide developed five years ago already combined TB and HIV responses and the mobile clinics that visit companies, are inclusive for both HIV counselling and testing and TB screening. Ms Dlamini however lamented that there are still challenges with this programming for informal sectors that tend to be highly migrant and cannot fund their own interventions.

It is therefore paramount that the commitment to defeat one of the most dangerous threats to humanity remains strong. We have to accelerate TB case findings, manage infection control and ensure early initiation of treatment for a high rate of successful treatment of all TB cases through increased awareness on TB prevention, treatment and management, especially among the most at risk and vulnerable populations like children,  women, people living with HIV, migrant and mobile populations. There is also need for continued funding commitment to ensure that this work transcends smoothly into the general health systems response for sustainability.

Alice Tembe, Citizen News Service - CNS 
9 April 2014