Professional Documents
Culture Documents
Floor
Westminster
House,
122
Longmarket
Street,
Cape
Town,
8001,
South
Africa
PO
Box
2069,
Cape
T own,
8000,
South
Africa
Tel:
+27
(0)21
422
1700
Fax:
+27
(0)
21
422
1720
www.tac.org.za
info@tac.org.za
NPO
Number:
043-770
VAT
Number:
4070239977
Registration:
2000/029181/08
Ekurhuleni
District
Office
Office
01,
2nd
Floor,
Golden
heights,
141
Victoria
Road,
Germiston,
Johannesburg
Gert
Sibande
District
Office
44
De
Clerq
Street,
Ermelo
Khayelitsha
District
Office
Town
1
Properties,
Sulani
Drive
Site
B,
Khayelitsha,
Cape
Town,
7784
Lusikisiki
District
Office
Embassy
Building,
Room
18
Jacaranda
Building,
Lusikisiki
4820
Mopani
District
Office
15
Peace
Street,Madentia
Park
,Tzaneen
Umgungudlovu
District
Office
st Idube
Building1
Floor
249
Burger
Street.PMB
3201
Directors
Nonkosi
Khumalo
(Chairperson)
Vuyiseka
Dubula-Majola
(General
Secretary)
Thembelihle
Dlamini
(Deputy
General
Secretary)
Nathan
Geffen
(Treasurer)
Mark
Heywood
(Non
Managing
Member)
To: Minister of Health, Minister Aaron Motsoaledi; Director General of Health, Dr Precious Matsoso; Deputy Director General, Dr Yogan Pillay; Director of TB department, Dr Lindiwe Mvusi; Director of Drug-Resistant TB, Dr Norbert Ndjeka. 22 March 2013
MEMORANDUM:
Step
up
the
implementation
of
Zero
infections,
deaths,
stigma
and
discrimination
from
TB
and
HIV
in
my
lifetime!
Today,
22
March
2013,
while
we
commemorate
World
TB
day,
we
need
to
take
stock
of
the
progress
we
have
made
in
fighting
the
disease.
Today,
TB
remains
the
number
one
cause
of
death
in
South
Africa.
Approximately
1%
of
the
South
African
population
develops
TB
disease
every
year.
That
is
500,000
people
per
year.
Despite
an
improvement
of
the
cure
rate
over
the
years,
the
treatment
success
rate
of
new
TB
infections
is
still
below
the
global
target
of
85%.
The
epidemic
is
further
compounded
by
MDR- TB
with
at
least
13,000
new
cases
projected
for
2013.
South
Africa
continues
to
carry
one
of
the
highest
TB
burdens
in
the
world.
We
welcome
the
Department
of
Healths
effort
in
scaling
up
its
campaign
for
testing
and
screening
for
HIV
and
TB.
We
sincerely
hope
that
the
DOH
will
reach
the
target
of
30
million
people
screened
by
2016
which
it
has
set
out
in
the
NSP
2012-2016.
We
furthermore
welcome
the
considerable
effort
of
the
NDOH
in
making
the
GeneXpert
available
across
the
country.
Today,
more
than
150
GeneXpert
machines
are
installed
and
a
further
125
are
planned
for
2013.
With
a
sensitivity
of
98%
(55-77%
in
smear-negative
cases)
and
a
result
within
90
minutes,
GeneXpert
should
drastically
reduce
the
time
to
diagnose
active
TB
disease
and
especially
drug-resistant
TB
(DR-TB).
This
should
lead
to
faster
initiation
on
effective
treatment,
less
time
for
TB
transmission
in
the
community,
less
risk
of
resistance,
and
ultimately
a
decrease
in
the
rate
of
new
infections.
However,
Honourable
Minister,
GeneXpert
can
only
make
a
difference
if
it
leads
to
faster
initiation
on
treatment.
For
this
to
happen,
we
need
uninterrupted
cartridge
supply
and
capacity
to
manage
DR-TB
at
primary
care
as
soon
as
the
patient
is
diagnosed,
this
includes
adequate
resource
allocation,
training
of
staff,
continuous
supply
of
TB
and
DR-TB
drugs
and
adequate
supervision
capacity.
Medicine
stock-outs,
as
we
saw
in
2012,
at
depots,
hospitals
and
pharmacies
increase
the
risk
of
developing
drug
resistance
and
endanger
the
lives
of
many
of
South
Africas
people.
Revision 4x-25/2/2011 RM
3rd
Floor
Westminster
House,
122
Longmarket
Street,
Cape
Town,
8001,
South
Africa
PO
Box
2069,
Cape
T own,
8000,
South
Africa
Tel:
+27
(0)21
422
1700
Fax:
+27
(0)
21
422
1720
www.tac.org.za
info@tac.org.za
NPO
Number:
043-770
VAT
Number:
4070239977
Registration:
2000/029181/08
Ekurhuleni
District
Office
Office
01,
2nd
Floor,
Golden
heights,
141
Victoria
Road,
Germiston,
Johannesburg
Gert
Sibande
District
Office
44
De
Clerq
Street,
Ermelo
Khayelitsha
District
Office
Town
1
Properties,
Sulani
Drive
Site
B,
Khayelitsha,
Cape
Town,
7784
Lusikisiki
District
Office
Embassy
Building,
Room
18
Jacaranda
Building,
Lusikisiki
4820
Mopani
District
Office
15
Peace
Street,Madentia
Park
,Tzaneen
Umgungudlovu
District
Office
st Idube
Building1
Floor
249
Burger
Street.PMB
3201
Directors
Nonkosi
Khumalo
(Chairperson)
Vuyiseka
Dubula-Majola
(General
Secretary)
Thembelihle
Dlamini
(Deputy
General
Secretary)
Nathan
Geffen
(Treasurer)
Mark
Heywood
(Non
Managing
Member)
We welcomed the departments policy framework on decentralised and deinstitutionalised management of DR-TB for South Africa in 2011. However, we have had to witness with sadness that two years later the policy framework has hardly been implemented. The provincial operational plans for decentralisation of MDR-TB care have not been drafted, nor have readiness assessments been conducted of all proposed decentralised MDR-TB units, satellite units and PHC facilities, nor have doctors and nurses been trained. We ask the honourable minister to report on the progress of the implementation of the MDR-TB decentralisation policy and assure us that clinically stable adults and children will be initiated and managed on DR-TB treatment in their local clinic in every province before the end of 2013. On 24 March 1882, Dr Koch announced that Mycobacterium Tuberculosis is the cause of Tuberculosis. Today, 131 years later, we are still treating patients with TB drugs that are 60 years old. Finally new drugs are being developed and tested. Bedaquiline is one example, and we welcome the open label trial to provide expanded access to Bedaquiline. However, currently there is only one primary care based site for initiation, in Khayelitsha; we need to increase the number of primary care based sites which are able to manage DR-TB adequately throughout South Africa to ensure our brothers and sisters elsewhere can access this potentially life-saving drug. Bedaquiline alone will not be sufficient, it needs to be given in a regimen alongside other drugs. We ask that other effective repurposed drugs be made affordable and therefore available. One such drug is Linezolid. This drug is highly effective against both MDR and XDR-TB but is extremely expensive in South Africa. Pfizer holds the patent in South Africa and sells Linezolid for R676 per tablet in the private sector and R287 per tablet to the government. Patients require one Linezolid tablet every day for many months. As long as Pfizer holds a patent on this drug in SA, patients will not have access to a drug that, in combination with other effective drugs, could save their lives. Only recently in the Western Cape, the drug coding committee decided against coding Linezolid for treatment of DR-TB with cost playing a major role in the decision. Our government has the means to its disposal to allow for importation of this drug from a generic company in India at a price of R10 per tablet. A compulsory licence is authorised both by article 31 of the TRIPS agreement, as well as by the South African Patent Act of 1978 when ... it is in the public interest that a licence or licences should be granted; The Department of Trade and Industry is currently devising a policy on intellectual property rights which will, amongst others, deal with trips flexibilities such as parallel importation, an examination office and compulsory licences. We urge the DOH to take an active interest in the development of this policy and not only protect the flexibilities that the DOH has to its disposal but build on them to actively advance the right to health for all South Africans. We need to prevent situations in which the pharmaceutical industry holds our health to ransom with monopoly prices on life-saving medicines, Linezolid being one of them. Despite the claim of the pharmaceutical industry that patents are necessary to stimulate innovation and economic development, evergreening through multiple concurrent patents on the same medicine violates patients rights to available treatment. Let us commit to reach zero infection, deaths, stigma and discrimination from HIV and TB today!!
Revision 4x-25/2/2011 RM
3rd
Floor
Westminster
House,
122
Longmarket
Street,
Cape
Town,
8001,
South
Africa
PO
Box
2069,
Cape
T own,
8000,
South
Africa
Tel:
+27
(0)21
422
1700
Fax:
+27
(0)
21
422
1720
www.tac.org.za
info@tac.org.za
NPO
Number:
043-770
VAT
Number:
4070239977
Registration:
2000/029181/08
Ekurhuleni
District
Office
Office
01,
2nd
Floor,
Golden
heights,
141
Victoria
Road,
Germiston,
Johannesburg
Gert
Sibande
District
Office
44
De
Clerq
Street,
Ermelo
Khayelitsha
District
Office
Town
1
Properties,
Sulani
Drive
Site
B,
Khayelitsha,
Cape
Town,
7784
Lusikisiki
District
Office
Embassy
Building,
Room
18
Jacaranda
Building,
Lusikisiki
4820
Mopani
District
Office
15
Peace
Street,Madentia
Park
,Tzaneen
Umgungudlovu
District
Office
st Idube
Building1
Floor
249
Burger
Street.PMB
3201
Directors
Nonkosi
Khumalo
(Chairperson)
Vuyiseka
Dubula-Majola
(General
Secretary)
Thembelihle
Dlamini
(Deputy
General
Secretary)
Nathan
Geffen
(Treasurer)
Mark
Heywood
(Non
Managing
Member)
Yours in the struggle, Vuyiseka Dubula General Secretary Treatment Action Campaign (TAC) Andrew Mews Head of Mission Mdecins Sans Frontires (MSF)
Revision 4x-25/2/2011 RM