Leg­is­la­tors tackle TB scourge

Lesotho Times - - News - Lim­pho Sello

L

EGISLATORS have es­tab­lished a cau­cus to fight the deadly tu­ber­cu­lo­sis disease by strength­en­ing ac­count­abil­ity in health fi­nanc­ing and en­sur­ing an ef­fec­tive im­ple­men­ta­tion of pre­ven­tive and treat­ment pro­grammes through­out the coun­try.

The leg­isla­tive cau­cus is made up of 21 mem­bers mainly drawn from the Port­fo­lio Com­mit­tee on So­cial Clus­ter and three oth­ers from other port­fo­lio com­mit­tees. The mem­ber of par­lia­ment for the Mabote Con­stituency who is also the chair­per­son of the Port­fo­lio Com­mit­tee on So­cial Clus­ter, Fako Moshoeshoe, said they would in­vest their time and en­ergy in the fight against the scourge which is one of the coun­try’s ma­jor killers. “To­gether with our part­ners, we would like to en­sure that by 2030 peo­ple will no longer die of tu­ber­cu­lo­sis,” Mr Moshoeshoe said, adding, “We are pas­sion­ate about this mis­sion be­cause tu­ber­cu­lo­sis is pre­ventable and cur­able”.

He said there was need for ad­vo­cacy for be­hav­iour change, en­forc­ing pre­ven­tive mea­sures and en­sur­ing there was early de­tec­tion of the disease.

He said the TB leg­isla­tive cau­cus had al­ready iden­ti­fied ap­proaches and plat­forms for ad­vo­cacy on re­forms in health fi­nanc­ing with spe­cific fo­cus on tu­ber­cu­lo­sis and re­duc­tion of the cost of care.

“We will lobby the gov­ern­ment to in­tro­duce a Na­tional Health In­surance, in ad­di­tion to strength­en­ing its in­clu­sive ap­proach by en­hanc­ing col­lab­o­ra­tive ac­tiv­i­ties with key stake­hold­ers in­clud­ing Non-gov­ern­men­tal Or­gan­i­sa­tions (NGOS) and the pri­vate sec­tor. This will help to im­prove so­cial ac­count­abil­ity to en­sure that we achieve more with lim­ited re­sources,” Mr Moshoeshoe said.

The leg­isla­tive cau­cus also in­tends to ad­vo­cate for the de­vel­op­ment and im­ple­men­ta­tion of a sus­tain­able pub­lic fi­nanc­ing model.

Mr Moshoeshoe fur­ther said the group would or­gan­ise an in­duc­tion pro­gramme for all par­lia­men­tar­i­ans, com­mu­nity lead­ers and school au­thor­i­ties to equip them to cham­pion the fight against TB cause within their sphere of in­flu­ence.

Mean­while, the United States (US) Am­bas­sador to Le­sotho, Re­becca Gon­za­les, says that Le­sotho re­mains a high bur­den TB coun­try with an es­ti­mated 16 000 new TB cases an­nu­ally.

She said this was de­spite the coun­try hav­ing enough Genexpert ma­chines that are used to di­ag­nose TB.

Ms Gon­za­les said this at the re­cent World TB Day com­mem­o­ra­tions which were held in Maseru un­der the theme ‘Wanted: Lead­ers for a TB Free World. You can make his­tory-end TB.’

The day is com­mem­o­rated ev­ery year on 24 March to re­flect on the progress of the fight against the disease.

Ms Gon­za­les said that although Le­sotho had enough di­ag­nos­tic ma­chines, they were how­ever, un­der-utilised due to the lack of car­tridges and main­te­nance agree­ments.

“Le­sotho cur­rently has the suf­fi­cient Genexpert ma­chines to di­ag­nose all sus­pected cases of TB. How­ever due to the lack of car­tridges, a lack of main­te­nance agree­ments, and lim­ited staff in lab­o­ra­to­ries, these di­ag­nos­tic ma­chines are not be­ing op­ti­mally utilised,” Ms Gon­za­les said.

Ms Gon­za­les said out of the 16 000 new TB cases ev­ery year, 75 per­cent are es­ti­mated to be co-in­fected with HIV. She added that TB is the lead­ing cause of death among in­di­vid­u­als liv­ing with HIV, ac­count­ing for one in three Hiv-re­lated deaths in 2016.

She how­ever, said the long term col­lab­o­ra­tions be­tween Le­sotho and her gov­ern­ment and its part­ners have re­sulted in ma­jor strides.

“Ninety nine per­cent of the reg­is­tered TB pa­tients now know their sta­tus while 90 per­cent of the reg­is­tered TB and HIV co-in­fected pa­tients are on an­tiretro­vi­ral treat­ment (ART). I am proud that the US gov­ern­ment has been a strong part­ner with Le­sotho in the fight against TB be­cause it means that to­gether we are sav­ing lives.

“How­ever, de­spite these ac­com­plish­ments, there is still much more to do in Le­sotho to con­trol TB. Over­all, Le­sotho still has a high bur­den of the disease,” Ms Gon­za­les said.

She said the mor­tal­ity rate re­mained high at ap­prox­i­mately 15 per­cent due to late di­ag­no­sis while 4.8 per­cent of the new cases were drug re­sis­tant.

Ms Gon­za­les said the scale up of Iso­ni­azid Pre­ven­tive ther­apy (IPT) among peo­ple liv­ing with HIV has been well be­low ex­pec­ta­tions as only about 25 per­cent of those el­i­gi­ble have re­ceived this in­ter­ven­tion.

“So, what can be done to turn his sit­u­a­tion around? Let me fo­cus on the three I’s: In­ten­si­fied case find­ing, IPT, and in­fec­tion con­trol. For each of these, we have in­ter­ven­tions that are cur­rently un­der-utilised.”

She said IPT was an ef­fec­tive and low-cost way to pre­vent TB disease in per­sons liv­ing with HIV but due to per­sis­tent short­ages of i so nico tinylh yd razi de( an an­tibi­otic) and Vi­ta­min B 6 too many Ba­sotho were not re­ceiv­ing the ben­e­fits of this in­ter­ven­tion.

“We need to ad­dress the sup­ply chain is­sues that have re­sulted in these stock­outs. Just as we would not ac­cept stock­outs of first line an­tiretro­vi­ral drugs, we can­not ac­cept stock­outs of INH and B6 at Na­tional Drug Ser­vices Or­gan­i­sa­tion (NDSO). IPT is a life-sav­ing in­ter­ven­tion that should be avail­able to all el­i­gi­ble per­sons liv­ing with HIV.”

She said of­ten TB trans­mis­sions also oc­curred within health fa­cil­i­ties af­fect­ing both pa­tients and staff and there was a need to achieve zero in­fec­tion in the health cen­tres.

“These fa­cil­i­ties are meant are meant to help peo­ple be­come well, not make them ill.”

For his part, Deputy Prime Min­is­ter, Monyane Moleleki, said the im­ple­men­ta­tion of work­ing strate­gies needs to start im­me­di­ately to en­sure that Le­sotho achieves its tar­get to end TB by 2030.

Mr Moleleki said the gov­ern­ment has to en­sure that prices of treat­ment are low­ered.

“We have more than 200 000 known pa­tients of TB so some­thing needs to be done.

“It is not only the Health min­istry’s re­spon­si­bil­ity but ev­ery­one’s to en­sure that we tackle TB. I am told that we are se­cond in the world among 30 high TB bur­den coun­tries,” Mr Moleleki said.

MP for the Mabote Con­stituency and Port­fo­lio Com­mit­tee on So­cial Clus­ter chair­per­son Fako Moshoeshoe.

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