The United States is proud to be one of South Africa’s most active partners in many areas of health and biomedicine, including tuberculosis. Our collaboration on TB prevention, control, treatment and research demonstrates how much our countries can accomplish when we work together to save lives and prevent illness. The short films we are here today to introduce clearly demonstrate the growing productiveness of our partnership.
Although there is
relatively little TB in the United States, we care deeply about controlling this
disease wherever it threatens lives. We learned important lessons a decade ago
when there were explosive U.S. outbreaks of multi drug resistant TB,
particularly in New York City. Up to that point we had grown a bit complacent
about the disease and assumed that it was disappearing in America. What we
learned was that when HIV is common in a population and where vigilant TB
prevention and treatment programs lag, the disease could and would return with
devastating effect. South Africa knows this and we commend the Department of
Health and its partners for giving special attention to controlling this very
dangerous disease.
As many of you here know, tuberculosis is a disease of antiquity that continues to cause sickness and death in the 21st century, especially because of its link to HIV. It is estimated that one-third of the world’s population is infected with TB leading to more than 8 million cases of active TB each year and 2 million deaths. On it’s own, TB is a public health emergency that demands the attention of governments and civil society. When tuberculosis occurs in communities with high levels of HIV, it is the leading cause of death. This HIV-TB challenge is what we are facing today in South Africa and in U.S. communities with high levels of HIV infection. The good news is that TB can be treated and cured, even in those who are infected with HIV. And, when HIV/AIDS also is treated, most people at highest risk for TB will live longer, more productive lives.
What works best to control and cure TB is “directly observed therapy short-course” or the “DOTS Strategy.” This strategy includes a package of care, which supports patients throughout the long course of TB treatment. Skilled health care personnel, well-equipped laboratories and social support services are required for DOTS to succeed. But most importantly the success of DOTS relies on community involvement and patients who actively seek care and take their medicines reliably. The videos we are seeing today were designed to stimulate this community and individual motivation.
To help support DOTS efforts around the world, the U.S. is a strong supporter of the Global Fund to Fight AIDS, TB and Malaria, to which the U.S. has pledged $1.5 billion (47% of its current funding). We are pleased that South Africa is one of the major recipients of Global Fund resources and that much of this support will be used to address the tuberculosis crisis. Although South Africa ranks 8th among countries with the highest burden of TB, the South African Government, NGOs, other partners are making important progress, especially to expand DOTS throughout the country.
The United States also is pleased that the Government of South Africa has expressed its interest in expanding our collaboration on other aspects of HIV-associated disease through the new White House initiative on the prevention of mother-to-child HIV transmission and through the new emergency plan to address AIDS, which was announced by President Bush in his recent State of the Union speech. There is much to be done and the U.S. is eager to continue its support for the reconstruction and development of South Africa. TB undermines efforts to build economies and exacerbates the cycle of poverty. Building and maintaining public health capacity to address TB is essential to building a strong South Africa. Our new programs will address this need for capacity development.
The specific U.S. Government agencies primarily involved in our current TB control effort are the US Centers for Disease Control and Prevention (CDC) and the Agency for International Development (USAID). In addition I want to personally thank the Medical Research Council, the NGO sector, and academia in South Africa for their work with us to address the TB emergency here.
USAID has enabled the first videw of its kind to be produced in this country, showing South Africans how they can prevent and treat TB. ‘Precious Breaths’ is a compelling documentary; the very human face of TB and the suffering we are all working to relieve is apparent in the faces of the children and adults struggling to overcome this illness. Let us all be further motivated by these real-life stories to overcome stigma, to reach out to persons with TB, and to help them take their medicines so they can live without suffering from this devastating disease.
We look forward to continuing our active partnership as we jointly intensify the struggle against TB and HIV.
Thank you.
