STATEMENT BY THE RT HON PRIME MINISTER
DR B.S.S.DLAMINI
AT THE TB/HIV HIGH-LEVEL EVENT HOSTED BY THE KINGDOM OF SWAZILAND
At Happy Valley Conference Centre, Ezulwini
21 MARCH 2013
Your Royal Highnesses
Honourable Ministers
Honourable Minister of Health, Government of the Republic of South Africa, Aaron Motsoaledi
Honourable Deputy Minister of Health, Republic of Zambia, Patrick Chukusu
Honourable Deputy Minister of Health, Republic of Zimbabwe, Douglas Mombeshora
UN AIDS Executive Director, Michel Sidibé
Vice-Chair of the Global Fund to Fight AIDS, TB, and Malaria
Board, Mphu Ramatlapeng
Executive Secretary, Stop TB Partnership, Lucica Ditiu
World Bank Country Director for South Africa, Swaziland, Lesotho, Namibia and Botswana, Asad Alam
International Medical Secretary, Doctors without Borders (MSF), Marc Gastellu-Etchegorry
Director: Migration Health Division International Organization for Migration, Davide Mosca
Executive Director of STOP AIDS NOW! Louise van Deth
Honourable Members of both Houses of Parliament
Distinguished Guests
Ladies and Gentlemen
May I start by expressing the very warmest words of welcome to the many of you who are visitors to our country, and assure you all of our pride and gratitude that the Kingdom of Swaziland has been given the opportunity to host this important event.
Whilst the contribution of every participant will be highly valued it is clear to all that the name “High Level” attached to this meeting is well justified given the presence of so many high profile, and thus crucially significant, players in the fight against tuberculosis (“TB”) and TB/HIV.
This meeting is designed to play a vital role in ending the TB/HIV co-epidemic in the Southern African Development Community and in Africa as a whole, and establishing and building upon the momentum for change.
As we all know, and all too well, the African continent has, since 1990, been hardest hit of all regions of the world with regard to the TB epidemic. While the burden has significantly reduced in all other regions, progress on this continent has been extremely slow. The consequences have been enormous in terms of individual suffering and death, tragedy and deprivation for families and communities, a huge drain on health services and a negative impact on economic growth.
As we are all aware, an individual infected with HIV will be particularly vulnerable to TB. And while recent years has seen, within SADC, the welcome introduction of simultaneous HIV and TB treatment it still represents a challenging endeavour, especially for the patient.
The African continent has 10% of the world’s population but 24% of the globally-notified TB cases, as well as the highest rates of TB per capita. Furthermore, the 15 countries of the SADC Region account for 55% of all TB notifications in Africa, which is clearly a significantly high burden.
TB in the mining sector remains a very substantial challenge – so many miners and ex-miners having fallen victim to the TB/HIV co-epidemic. The South African mines employ workers from all across SADC - countries which include Swaziland. Many miners have returned to their home countries in serious ill-health as a result of TB and HIV co-infection. This has given rise to high morbidity and mortality rates. Up to 33% of the TB infections in sub-Saharan Africa, which is 760,000 cases per year, arise from the mining sector of the southern African countries.
This has exacerbated what is already a major public problem, particularly in South Africa, Swaziland, Lesotho and Mozambique. It is against this background that the respective Ministers of Health of the governments of Swaziland and South Africa, together with the former Minister of Health of the Government of Lesotho have increased advocacy on TB and HIV in the mines. The SADC Declaration on TB in the Mining Sector brought political momentum to the issue in order to motivate and catalyse a collective response from the respective countries and sectors within those countries.
The timing of this High Level event is an ideal opportunity for global health leadership to call for greater progress following the August 2012 signing of the Declaration on TB in the Mining Sector by 14 SADC Heads of State. That declaration called for zero HIV and TB deaths and for enhanced partnerships between governments, the corporate sectors and the development partners. Significant progress has been realized with the recent release of the PEPFAR Blue-print for an AIDS-free Generation that prioritizes TB/HIV action. The UNAIDS organization and Stop TB Partnership have recently signed a memorandum of understanding calling for accelerated action in 10 African countries to reduce TB/HIV related deaths, many of which are in the SADC Region.
His Majesty’s Government is satisfied that a great deal has been achieved in the national response to the TB and HIV epidemics in the Kingdom but we are aware that much remains to be done. Now is not the time to be complacent. In the Kingdom, 80% of TB patients are already infected with HIV. Looked at from another perspective, no fewer than a third of HIV patients are also infected with TB. The impact of TB on a vulnerable immune system is causing high levels of mortality among the people living with HIV.
Having already declared HIV and AIDS a National Emergency, His Majesty’s Government declared a similar state of National Emergency in respect of TB back in March 2010. This declaration recognized the need for extraordinary measures to arrest the TB and HIV co-epidemic. The declaration propelled the Kingdom and our partners towards implementing an Emergency Action Plan. This Plan has included raising community awareness extensively, increasing the numbers of qualified human resources, and the expansion of TB diagnostics in health care facilities. The new reinforced commitment was backed up by the commissioning, in 2012, of the state-of-the-art National TB Reference Laboratory in Mbabane, which I understand some of our visitors will have had the opportunity to visit. This facility has the capacity to diagnose multi-drug resistant TB using liquid culture as well as using modern molecular methods. As a result, our TB case detection rate has improved markedly resulting in early and accurate diagnosis and treatment.
The objectives of this High Level event are worthy ones, and, in domestic terms, a most welcome addition to the ongoing efforts of His Majesty’s Government. What do we envisage as the impact of your deliberations?
In the first place, you will be raising political awareness and commitment for an accelerated response to the TB and TB/HIV emergency in Africa in order to help get Africa on track to achieve the TB and TB/HIV targets of the Millennium Development Goals by 2015.
Secondly, you are mobilising a consortium of global development and health leaders from governments, corporate sectors, development partners and multilaterals who are committed to ending TB and HIV in SADC and beyond.
We expect you, also, to initiate a collective response to the SADC Declaration on TB in the Mining Sector and related cross-border issues.
And, finally, you are serving to maximize the publicity and momentum, with a focus on new collective commitments and action, in order to elevate the global priority for TB, HIV, and TB/HIV in key political fora.
May I take this opportunity to urge you to apply all your knowledge and your ideas for innovative and implementable solutions on how we can focus our efforts in the next 1000 days to halt the TB and HIV epidemics and achieve the Millennium Goals for our countries and for Africa.
In conclusion, ladies and gentlemen, I urge all political, financial and health sector players to join hands to achieve the practical realization of the Heads of State and Government Declaration on TB in the Mines, and the African Union Declaration of TB as an Emergency. We are asking for a renewed commitment to stop the spread of TB in the mines and TB and HIV transmission in our communities .
Let us remember that “High Level” can only translate into High Impact if the messages and resolutions at this high level are accepted and implemented at grass roots level where the problem manifests itself.
It is now my honour, on behalf of His Majesty’s Government, to declare this TB/HIV High Level Event, on ending the TB/HIV co-epidemic in SADC, officially open.
Thank you.