STATEMENT BY THE RT HON PRIME MINISTER

DR B.S.S.DLAMINI

AT THE LAUNCH OF THE TB CLINIC AT THE BAYLOR COLLEGE OF MEDICINE

AT THE BAYLOR COLLEGE OF MEDICINE, MBABANE

FRIDAY 8 MAY 2015

Honourable Minister for Health

Your Excellency United States Ambassador

Director of NERCHA

Chief Executive, medical and other staff of the Baylor Clinic

Distinguished Guests

Ladies and gentlemen

The HIV and AIDS pandemic would go on to do far more damage than was originally envisaged in the early days of recognition of the HIV virus and the estimated impact. Many thousands of individuals would lose their lives in those cruel days before anti-retroviral treatment (ART) was rolled out in Swaziland. Large numbers of families and, indeed, communities, across the land, were devastated. The economy itself suffered a great deal of damage as huge losses among the young adult generation, and absence through illness, presented a crippling challenge for employers.

One of the most tragic and poignant implications of the pandemic was the catastrophic effect on so many children. In the early days, mother-to-child HIV transmission (MTCT), during or after birth, carried a high probability. In the developing immune system of a child, the degree of vulnerability to opportunistic diseases was especially high. To witness the subsequent death of a child through AIDS was to encounter as dreadful a tragedy as one could ever imagine. And the impact on the lives of thousands of other children, mostly those orphaned through HIV and AIDS, and their increased vulnerability in so many respects, was to rub more salt in the national wound.

Then, we as a country, made a great deal of progress, supported by a massive, and enormously appreciated, programme of assistance from our development partners. ART has been rolled out to around 90% of those requiring the medication, and MTCT itself has been reduced almost to zero.

But caring medically for all the children undergoing ART, as well as drawing into the net all those needing to be tested and, where necessary, placed on ART, required an intensive effort.

And, then, in stepped the Baylor Foundation, building this Baylor College of Medicine – Bristol Myer Squibb Children’s Clinical Centre of Excellence that was officially opened by His Majesty King Mswati III on 24 February 2006.

What a marvellous initiative and what an excellent programme that was launched! For simplicity, I will call the organisation the Baylor Foundation and this building and its components the Baylor Clinic. And say how pleased I am to have been able to join you all today.

When the Baylor Clinic was opened, it held an initial vision of “A healthy and fulfilled life for every HIV infected or affected child and family.” And three years later, in 2009, the Foundation established two satellite clinics, one to each of the Raleigh Fitkin Memorial (RFM) Hospital in Manzini and the Hlathikulu Government Hospital, the commissioning ceremony for which I had the honour of attending.

To meet the medical and social needs of children and their families, the Baylor Foundation has steadily expanded the range of services offered. In addition to comprehensive HIV prevention and care, the Foundation offers free integrated, services for TB, malnutrition, other non-infectious diseases and psycho-social support for adolescents, comprehensive women’s health services, including antenatal care, family planning, and cervical and breast cancer screening as well as under-five services for children.

This has been a strategic partnership of true excellence, to the extent that there is a Memorandum of Understanding between our Ministry of Health and the Baylor Foundation, backed up by an annual subvention from Government to support the work of the Foundation.

The special threat presented by TB prompted this partnership to take a special and dedicated approach to tackling that disease and the particular challenge that it presented to children. The presence of HIV had increased the extent of TB as an opportunistic disease among adults. That, in itself, increased the risk for children, and there was the additional vulnerability to TB that existed in children and the particular difficulty in diagnosing the symptoms in that age group. Increasing evidence suggests that TB may be an important primary cause of illness and death in children

These factors added a special and challenging dimension to the medical vulnerability and care needs of children. In this context, the country has prioritized the management of TB in children. The Baylor Foundation is one of the key implementing partners for this agenda.

How appropriate, then, that today we are commemorating the opening and dedication of the new TB Clinic of Excellence here in the Baylor Clinic building in Mbabane.

As a Paediatric Foundation, Baylor is well positioned to go beyond providing services to those who visit the TB Clinic, and will also be the resource centre that will provide mentoring and continuous capacity building to the other health facilities. This will greatly enhance and improve TB management across the entire country.

Throughout the world, childhood TB has historically been neglected, with statistics that are somewhat chastening. I believe we can be encouraged in the knowledge that the Kingdom of Swaziland is one of the countries taking purposeful and productive steps to bring attention to TB in children as one of the priority areas in the national TB response. This new Clinic is visible evidence of a further and most significant step in that programme.

The TB Centre of Excellence will, in a nutshell, assist Swaziland to improve the health of the future generation, through improved identification, treatment, and outcomes of children affected by TB and, in due course, achieving the goal of reaching “zero TB deaths among Swazi children.”

I understand that this TB clinic is uniquely designed for children, having state-of-the-art equipment for the laboratory, X-ray and consultation rooms. The one-stop, one-day comprehensive testing service and prompt commencement of treatment demonstrates the first-world standard of medical attention that our children will receive. And free of charge!

Since it is essential that such high quality medical care extends beyond this urban centre, the Clinic will also provide training and mentoring for health care workers across Swaziland, through nurse and doctor attachments. Additionally it will generate best practices for sharing and learning for all health workers in the management of children with TB.

The Clinic will also lead the national paediatric TB research agenda under the National TB Control Programme, in collaboration with internationally-recognized institutions and the scientific community. Such research will be a basis for new strategies in finding better tools to diagnose, prevent and treat TB, and inform the development of improved policies to address the specific needs of Swazi children in the most cost- effective way.

May I now express the profound gratitude of His Majesty’s Government to the Baylor Foundation for its generosity, and add our deep appreciation to the doctors, nurses and other staff of the Baylor Foundation facilities in Swaziland, who have brought high quality medical knowledge and care skills to our country and to our children, the future of Swazi society.

It is now my honour, on behalf of His Majesty’s Government, to declare the new Baylor TB Clinic of Excellence officially launched.

Thank you.