The health ministers of Lesotho, Swaziland and South Africa are rolling up their sleeves to tackle the alarming spread and increasing drug resistance of tuberculosis.
They have formed a sort of “A-Team” against TB with the same can-do attitude of the popular television series. And while they shun the sort of undercover approach of Mr T and his gang, they clearly take the fight personally.
“TB is already laughing at us, saying ‘I am just transforming!’” Mphu Ramatlapeng, a physician and health minister in the tiny kingdom of Lesotho, said in a lilting, mocking voice.
The trio, which spoke to the German Press Agency dpa, was in Washington on Tuesday for the annual board meeting of the Stop TB Partnership.
The programme, which is attached to the World Health Organization, aims to push tuberculosis up the world’s political agenda. That means that South African Health Minister Aaron Motsoaledi, Swaziland Health Minister Benedict Xaba and Ramatlapeng are also traipsing up to Capitol Hill to state their case for funding.
Motsoaledi made headlines last summer by donning his doctor’s white coat to help during a nurses strike. Now he is working with the unions, company owners, labour officials and others to get out the word about TB.
He compares tuberculosis, which infects one in every 100 South Africans, to a snake whose head is in South Africa and tail is moving to other African countries.
Because of the centrality of South Africa especially in the mines, his country draws workers from across the region. But many return home infected with TB and its co-conspirator, AIDS, and the health system loses track of them.
That’s why the trio is hatching a regional plan to include employers, unions, labour and immigration ministers as well as health departments in the fight within the regional group, the Southern African Development Community.
The United Nations warned last week that as many as 8 million people would die of tuberculosis worldwide by 2015 without a successful global health strategy.
HIV/AIDS has been midwife to the growing TB crisis, reducing immunities to the infection.
But patients such as miners who cross the region’s porous borders have also contributed by prematurely ending treatment. That is blamed for ever more virulent forms of multiple-drug-resistant tuberculosis (MDR-TB) and even extensively drug-resistant tuberculosis (XDR-TB).
All three countries have MDR-TB hospitals to handle the escalation.
“We don’t like it. The more people we put in there, the worse it is,” Motsoaledi said.
Swaziland last week declared tuberculosis a national emergency.
Xaba, its burly health minister, worked as a nurse at the grassroots level with with HIV and TB before becoming minister.
The trio’s efforts were energized earlier this year by the debut of the first major new technology breakthrough for TB in decades.
The GeneXpert TB machine can diagnose sputum for TB and drug resistance within 90 minutes, an enormous improvement over the weeks and even months previously needed for diagnosis — time during which many TB victims were lost to the system or even spreading the infection.
Motsoaledi unveiled South Africa’s first GeneXpert last week in the community of eThekwini, which has 45,000 TB cases — the highest in the country. The extensive television coverage did not escape notice in the region.
“My house cleaner, with second-grade education, said to me when I got home that night, ‘When are you going to get this machine like the South African minister has?’” said Xaba, laughing.
Door-to-door efforts are essential in the TB battle. In mountainous Lesotho, community workers ride horses to pick up sputum samples for testing and bring patients in for treatment. In Swaziland, TB patients who are no longer contagious use motorcycles.
“There is almost no stigma any more. Almost everyone gets tested for HIV and TB,” Ramatlapeng said.
Dr Lucica Ditiu, a Romanian physician and director of the Stop TB Partnership, said the big challenge of 2011-15 is “transforming the fight” to derail the vicious disease.
One arrow in her quiver, she said, is the relatively untapped resource of the BRIC countries — Brazil, Russia, India, China — along with South Africa. Newly advancing economies with increasing political clout, the BRIC countries are also TB and HIV hotspots that need to make sure their own fight is properly funded, and that they are helping across borders.
“We keep looking for traditional donors,” Ditiu told dpa. “It’s time to look at non-traditional donors, to see what they can do.”