Introduction

Welcome to Durban

It gives me great pleasure to extend an official and warm welcome to all of you, to the 7th South African TB Conference. As the Province of KwaZulu-Natal and the City of eThekwini - "where the sun never sets, and the fun never stops" - we are extremely honoured and proud to host this all-important gathering.

Undoing KZN's reputation as the "epicentre of TB and HIV and Aids

Given our status as the epicentre of TB and HIV and AIDS in the country, it is fitting - and certainly not by mistake - that a conference of this significance and magnitude is taking place in our Province. But, being the epicentre of this "double pandemic" of TB and HIV and AIDS is a badge that we certainly do not wear with pride. It is certainly something that we remain committed to bring to an end, through continuous hard work and consolidation of the relationships that we enjoy with our various social partners, as well as with the public at large.

A snapshot of where we are as KZN:

Although KwaZulu-Natal has the highest TB caseload, with eThekwini Metro carrying the highest burden, it is somewhat comforting to note a decline in TB Notifications in all districts, since 2018.

We remain concerned about our rate of TB case finding, which started dropping during the 2019-20 financial year. This, we believe was due to the disruptions caused by COVID-19, which made it difficult for many people to come to healthcare facilities.

We're nevertheless encouraged by the recent improvements in our rate of TB case-finding, which we've started seeing. In terms of averages, our numbers have declined from 1128 in 2012 to 372 per 100 000 population, as of the past financial year. While this is promising, it is still problematic, as it is almost twice the volume that the WHO declares a crisis, at about 200 per 100 000 population.

Therefore, we have every reason to be concerned, because TB remains the leading cause of death in our country, including in our province of KZN. It becomes even more concerning when you consider the fact that TB is both a preventable and curable disease. It is also a glaring indication that we, as the Department of Health, are simply not finding enough people with TB from our communities.

The role played by our Centre of Excellence:

But even with our challenges, we are quite pleased with the contribution that is being made by our TB Centre of Excellence, which is situated at King Dinuzulu Hospital, as well as the 54 decentralised sites. These facilities are assisting greatly in terms of training of staff, as well as the management of patients, particularly those aged under 15. We also welcome all ongoing efforts for clinical trials, which we hope will ultimately lead to a new shorter regimen for TB Treatment. We believe this will reduce our rate of "Loss to follow up" treatment, as well as the TB mortality rate.

We also believe it will also lead to a lesser pill burden, which is good news.

Effect of Covid-19 on usage of Gene Expert Ultra

In 2019, we launched the Gene Xpert Ultra machines. These machines have borne positive results, as they have a higher performance and are able to produce TB test results faster. They also have a higher sensitivity, especially in smear-negative TB cases. We’ve also come to realise that we would benefit greatly as a Province from the addition of more mobile Gene Xpert Ultra units, as they would significantly improve access to TB screening and testing, particularly for communities in rural areas.

We believe more mobile units should be provided, so that we can improve access to TB screening and testing, which will, in turn, improve our case finding and further reduce our TB death rate.

The urgent need for better funding to communicate, educate our people about TB:

Our TB statistics further indicate our urgent need for greater focus on education and awareness of the signs and symptoms of TB, among other interventions.

This would help engender a culture of TB prevention; early presentation for screening, testing and treatment; as well as adherence to treatment. Key to all of this is our ability to intensify our community outreach programmes, and to drive strong and sustainable mass communication efforts - all of which does not come cheap. Unfortunately, the budgetary cuts that we've been subjected to, have made our job harder. And, this is something that we continue to appeal to the National Department of Health, and to Treasury, to assist with.

Siyacela nisisize, Deputy Minister.

While we live in hope of receiving increased funding to address our many challenges - including staffing - we will nevertheless continue to strive to prevent, control and treat TB through various strategies. This includes training and research activities, as well as a TB/HIV integrated approach, which is an integral part of our response strategy.

Our TB programmatic response is guided by the National Strategic Plan for HIV, TB and STIs (2017-2022). Its chief aim is to achieve the National 90-90-90 targets for TB, as outlined in the Stop TB Partnerships' Global TB Plan; as well as the National TB strategy for Finding TB Missing Cases. We will continue to offer greater laboratory coverage for Gene Xpert Ultra and microscopy, which is available in all hospitals and Community Health Centres (CHCs).

Conclusion

As the Province of KwaZulu-Natal, we remain committed to turn the tide against TB, HIV and AIDS, by doing the following, among others: Strengthening case finding in and beyond healthcare facilities and; Placing greater focus on TB prevention for people living with HIV, particularly earlier initiation and scaling up of Anti-Retroviral Therapy; and Scaling up continuous TB preventative therapy.

We are of the firm belief that, in 2022, even as a developing country, we should not continue being held hostage by a disease that is preventable, treatable, and curable.We therefore welcome the gathering of heads at this SA TB Conference, to seek practical and sustainable solutions to reversing the tide of TB, now and forever, for the benefit of posterity.

With those few words, I would like to wish you everything of the best with all your deliberations over the next four days.