MEDIA RELEASE
NO. 74/ 2010
05 FEBRUARY 2010

The City of Cape Town’s Health Portfolio Committee was delighted this week to receive feedback on the award ceremony of the United Nations during which the City, Provincial Department of Health (Metro District Health Services) and TB/HIV Care Association were awarded for the fight against Tuberculosis (TB), but at the same time noted that there is still room for improvement in this difficult task.

The City’s Administrative Support for TB Programme, City Health Cape Town, was nominated by Impumelelo, an organization that promotes good governance, for a United Nations Public Service Award in 2009. The nominated project is a partnership between City Health, the Provincial Department of Health and the TB/HIV Care Association. The partners were the joint recipients of an Impumelelo Platinum Award in 2008 for this project.

The project involves a creative response by health officials to two different problems affecting poor communities in Cape Town. The one problem is that the incidence of TB had been rising consistently over the last 10 years while cure rates remained static, some of the reasons being that diagnosed patients failed to complete the lengthy treatment or response to treatment was not adequately documented. TB treatment requires intensive monitoring and precise documentation to successfully cure a patient, and to record this cure. Nursing staff in health clinics typically come under intense pressure to attend to waiting queues of patients with the result that they tend to overlook both monitoring and recording, with the consequence that many patients are lost to follow up or response to treatment is not adequately documented.

The second problem, though not directly a health issue, is the question of youth unemployment – especially of recently matriculated learners who are unable to find a foothold in the formal economy. This is especially prevalent in poor urban communities.

The innovative step taken by health officials was to bring the two problems into a common focus and to conceptualize a new layer of health workers to be added to clinic staff. The concept, in brief, was to recruit the new staff from among unemployed school leavers and to employ them as TB Assistants and TB Clerks with responsibilities for the monitoring and recording of all TB treatment schedules.

The project passed two rounds of selections for the UN award and the City was informed in May last year that it was selected as a finalist for the award of Improving the Delivery of Services. Partners of the project were requested to send a representative to the Awards Ceremony held in New York last year June.

Over 400 participants, including the Secretary-General of the United Nations, Mr Ban Ki-Moon and the Deputy Secretary-General for Economic and Social Affairs, Mr Sha Zukang, attended the ceremony at the UN Headquarters in New York. After speeches by the afore-mentioned, Mr Ban Ki-Moon presented the awards. The representative of the Western Cape Department of Health received the award on behalf of all three partners.

Cllr James Vos, Chairperson of the Health Portfolio Committee, said he was very proud of this achievement, but also highlighted that the hard work needs to be maintained and improved. “We aimed to work with the Provincial Health Department and TB/HIV Care Association to mainstream a multi-sectoral response that mobilises all City sectors to fight HIV/Aids and TB, thereby reducing the number of new HIV infections, especially among the youth, and also reduce transmission of TB in our communities.”

Vos added that in the view of the multiple factors contributing to the pandemics and the sheer scope and impact of these, it is clear that turning the tide of HIV/Aids and TB requires the involvement of all sectors. “Our aim is to reduce the impact of HIV/Aids on individuals, families and communities, including the City’s workforce, and reach a 85% cure rate for new smear positive TB cases.”

Cape Town continues to have an extremely high number of TB cases with 28 956 reported cases in 2009 and an incidence rate of 877 per 100 000 (compared with a national figure of about 500 per 100 000).

Factors that fuel TB in Cape Town include:

• Poverty
• Urbanization with resultant overcrowding
• Damp, poorly ventilated houses/shacks
• High HIV prevalence
• Clients presenting or being identified late in the course of the disease (so can infect many others before treatment)
• Poor treatment outcomes due to treatment interruption (defaulters)
• Substance abuse
• Smoking

Despite this high incidence rate, the City managed to achieve the best cure rate for TB, almost 80%, out of all Metro’s in the country last year. “Improvements in TB outcomes have been achieved in the last number of years, which need to be maintained or further strengthened at some sites. There is a high co-infection rate with HIV, so integration with HIV care is important,” said Vos.

The City’s TB Targets for 2009/2010 are:
• New smear positive TB cure rate per quarter: 78%
• Slow the rate of increase of TB per 100,000 of Cape Town Population: ≤1,090
• % TB Clients tested for HIV: 90%
• % HIV-positive TB Clients that had a CD4 Count: 95%


END

ISSUED BY:
COMMUNICATION DEPARTMENT
CITY OF CAPE TOWN


MEDIA QUERIES:
Cllr James Vos
Chairperson for the Health Portfolio Committee
Tel: 021 590 1680 Cell: 083 640 7640