Govt announces plans to combat TB

Namibia, which has the highest tuberculosis (TB) notification rate in the world, this week announced a five-year action plan to combat the disease. The plan includes increased investment in healthcare and medical personnel, more laboratories, and intensified TB information and communication campaigns. According to the World Health Organisation (WHO), an average of 676 cases of TB are recorded for every 100,000 Namibians, putting the country at the top of the world ranking for the disease. In 1996, the notification rate stood at 598 cases per 100,000 Namibians. The reasons for the high TB rate in Namibia were "not exactly known", said a situation analysis included in the five-year action plan. The analysis listed HIV infection, which is driving the TB infection rate, as well as overcrowding, poor ventilation, smoking, poor nutrition, alcoholism, stress, cancer, diabetes and pregnancy, as factors that made people more susceptible to contracting the disease. "TB is the principle cause of death in people living with AIDS" in Namibia, the report said. "About 50 to 60 percent of TB patients are HIV positive, [so] it can be calculated that 115,000 persons in the country are dually infected with TB and HIV." According to UNAIDS, at the end of 2003 about 200,000 Namibians were living with HIV/AIDS. "Between 5,000 to 10,000 of those persons will develop TB disease each year because of immune suppression caused by HIV infection, in spite of the presence of a well-functioning TB control programme" in Namibia, the report warned. The government introduced WHO's Directly Observed Treatment Short-Course (DOTS) strategy in 1996, which includes free medication and treatment at all government hospitals over the six-month course of medication. However, DOTS resulted in a treatment success rate of only 65 percent, instead of WHO's international target of 85 percent. "Too many patients stop taking their medication before they have successfully completed treatment, or die because of late diagnosis or HIV/AIDS, or because they develop multidrug-resistant tuberculosis," the report revealed. In 2003 Namibia received US $700,000 from the Global Fund to Fight AIDS, TB and Malaria. Implementing the strategic plan to combat TB, means the country will need another $41.6 million over the next five years to effectively reverse the epidemic. "Improving socioeconomic living conditions and stopping HIV/AIDS are the most potent and long-term determinants in bringing the TB epidemic to a halt and reversing its trend," said the report, compiled with the assistance of WHO and the Royal Netherlands Tuberculosis Association.