The Sunday News
Robin Muchetu, Senior Reporter
ZIMBABWE has been removed from the World Health Organisations (WHO) list of top 30 countries that have a high tuberculosis burden, a situation attributed to robust media campaigns, availing of specialised machinery for testing and training of health workers.
The list provides a focus for global action on TB, HIV-associated TB and drug-resistant TB in the countries where progress is most needed to achieve the targets set in WHO’s End TB Strategy. TB is regarded as the world’s deadliest infectious killer disease with 4 000 people losing their lives to it daily, yet it is curable.
Zimbabwe in 2019 received 21 577 notifications, 25 775 in 2018, 26 401 in 2017 and 27 353 in 2016. The cases have been declining since 2016 when the targets were set out. Cambodia, the Russian Federation and Zimbabwe have transitioned out of the 2016 list while Gabon, Mongolia and Uganda have joined the list.
Dr Charles Sandy, the National TB Programme Manager in the Ministry of Health and Child Care explained what it meant for the country to be out of the list and the various interventions in the national response to TB made so far.
“The implication of the categorisation is a reflection of the progress made over the past few years in reducing the incidence of TB to the extent that we are no longer among the top 30 countries. The focus of the national response was to raise awareness through the media, training of health workers, capacitation of the health through system creation of additional laboratory services and more sensitive and specific molecular tests (geneXpert), introduction of digital x-rays, integrated approach to TB and HIV care,” he said.
The major challenges that were experienced during implementation were largely related to raising adequate resources to support the total needs. Dr Sandy said Zimbabwe was the least in terms of incidence rate for the 10 countries who were placed in the group due to incidence rate.
“We are still a high incidence country and have a long way to go to reach the End TB target. The incidence rate for 2020 was estimated at 199 per 100 000 which is still high,” he said.
Dr Sandy said on the other hand it also means Zimbabwe is no longer a global priority focus country and inadvertently may lead to less global investment in the National TB response.
“The risk of this is that as incidence declines the TB cases become more elusive to detect and cost more to identify necessitating a greater need for more investment for an effective response rather than less. This conundrum is, however, not easily appreciated by funders and policymakers,” he said.
Going forward, Dr Sandy said the country should invest more in this sector despite coming out of the list of countries burdened by TB.
“There is a need to continue to invest more in a robust accessible high quality health system for a sustainable TB response and to address the social determinant of poor health for even more accelerated elimination of TB (housing, nutrition, smoking, alcohol),” he said.
He added that the Ministry of Health and Child Care’s National TB Programme (NTP) had scaled up TB diagnosis using the WHO recommended rapid diagnostic tests, introduced shorter and safer preventive TB treatment regimens, introduced child friendly formulations and a shorter all oral (injection free) treatment regimen for treating Multi-Drug Resistant-TB.
In a bid to scale up detection of TB cases in communities that are hard to reach, the NTP is also conducting targeted active TB screening in these communities at high risk using mobile X-ray trucks. TB is an infectious disease caused by a bacterium (Mycobacterium tuberculosis) that most often affects the lungs although other parts of the body such as the brain, heart and bones can be affected.
It is spread from person to person through the air when people with TB cough, sneeze or spit. In Zimbabwe screening, diagnosis and treatment for TB is provided free of charge at all public health institutions. — @NyembeziMu.
