Von Delft Part 2 - Treatment Action Group

Why are new drugs and cheaper,
more user friendly regimes needed?
"Tuberculosis, whether caused by drug-susceptible or drugresistant strains, rarely made even medical headlines, in part
because its importance as a cause of death continued to decline
in areas in which headlines are written.”
Keshavjee and Farmer, NEJM, 2012*
And what TB
* Tuberculosis, Drug Resistance, and the History of Modern Medicine. Salmaan Keshavjee and Paul Farmer. N Engl J Med. 2012 Sep 6;367(10):931-6.
“…selective primary health care and ‘cost-effectiveness’ have shaped
an anemic response to the ongoing global pandemic.”*
*Tuberculosis, Drug Resistance, and the History of Modern Medicine. Salmaan Keshavjee and Paul Farmer. N Engl J Med. 2012 Sep 6;367(10):931-6.
Slide courtesy: Prof Keertan Dheda
SA : MDR-TB already >55% of TB budget!
Financing the scale-up of MDR-TB prevention and Treatment. Katherine Floyd, Stop TB, WHO. Ministerial meeting. Beijing, China, 2009
The perception among the majority is that we are not at risk of being infected by TB.
This assumption is deeply flawed.
Dr Madhukar Pai, India Tribune, 29 October 2012
The RNTCP needs to think beyond treatment of drug-resistant TB, and focus on
preventing a major epidemic. In the case of drug-resistant TB, an ounce of prevention
is definitely better than a pound of cure
Care for the carer
• ±1/100: number of South Africans diagnosed with TB
last year (WHO, 2012).
• 3x: increased rate of TB among Health Care Workers
globally (Baussano, 2011).
• 6.3%: confirmed drug-resistance among occupational
TB cases at Tygerberg Hospital (Data: 2008-2011).
• 5.56x higher incidence rate of MDR- and XDR
(O’Donnell, 2010)
• Means 3/100 HCW’s could be diagnosed with TB every
• At least 1/16 could have MDR-TB or worse
Lucky and thankful…
• Dalene got her life back, she can still hear, and
can even practice as a clinician again…what
Start at the beginning:
Year Medical Students
Anyone can get TB
Nobel peace prize TB survivors
“UBUNTU” – I am because we are
We are all in this together!
HOPE: Life after TB
SA record: 114m in one breath!
Paul Willcox
Andreas Diacon
Simon Schaaf
Tony Biebuyck
Jantjie Taljaard
Keertan Dheda
Gary Maartens
Elsimé Kift
Jeannine Du Bois
Justus Apffelstaedt - Surgery
Mou Manie - Rheumatology
Anton Doubell - Cardiology
Mark Abelson – Cardiology
Prof Loock – Ear, nose and throat
Sucari Vlok
Arthur Maydall
Jan Lotz
Occupational Health/TBH
Jack Meintjies
Sr Samuels
Sr Arendse
Matodzi Mukosi - super
Elmarie Malek
Mariana Kruger
SAMA - Daniel Madiba
Thank you!
Gerhard Walzl
Belinda Kriel
Daleen Kriel
Rob Warren
Tommie Victor
Soraya Bardien-Kruger
Lizma Streicher
David McNeeley
Gilles van Baar
Mariza Hoffman
Haematology and Microbiology
Rene Visagie
Sharon Pithey
Tygerberg Audiologists
Nesri Padayatchi
Kogieleum Naidoo
Angela Dramowski
Bart Willems
Heena Narotam
Helene-Mari van der Westhuizen
Koot Kotze
Treatment Action Group
“The momentum to break this disease is in real danger. We are now at a
crossroads between TB elimination within our lifetime, and millions
more TB deaths.”
Dr Mario Raviglione; Director of the WHO Stop TB Department;
17 October 2012

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