Statement by the SADC Ministers of Health on XDR TB

22 September 2006

A meeting of SADC Ministers of Health, chaired by the Minister of Health of Lesotho Dr Phooko, was convened in the morning of the 22 September 2006 during the Second Session of the AU Ministers of Health in Mozambique Maputo.

The objective of the meeting was to discuss the status of Extremely Resistance Tuberculosis (XDR TB) in the region. XDR TB is multi-drug resistance tuberculosis that does not respond to at least three of the second-line TB treatment.

Globally, this strain has also been reported in several other countries including the USA and Latvia, which have 4% and 19% prevalence rates respectively.

At the SADC Ministers of Health meeting, the Minister of Health of South Africa Dr Manto Tshabalala-Msimang shared the South African experience and challenges in addressing XDR TB.

Cases of XDR TB were found in a hospital in the province of KwaZulu-Natal in South Africa. Subsequently, there have been reports of a small number of additional cases in Gauteng and Free State provinces.

This could mean that there are other XDR TB cases in the country and in the region as these reported cases were identified by special interventions.

The outstanding challenges are as follows:

In the past 30 years, no new TB drugs and diagnostic tests were develop, thus making XDR TB much more difficult to treat because of the limitations of drugs.
The strain is resistant to the first-line of TB drugs, and in addition to these drugs, it is also resistant to at least 3 of the second-line TB drugs.
Effective treatment of TB requires more than 2 drugs, which then means that we have to bring back the drugs that were taken off shelves due to their side effects and toxicity.

Ministers agreed that there is MDR in the African region, and noted the new development of XDR TB cases.

The Ministers also agreed that the magnitude of the problem of XDR TB in the region needed to be determined.

Ministers agreed that the XDR TB challenge would need a regional approach, taking into consideration the free movement of people within the region and continent.

Proposed way forward:

To strengthen the normal TB programme within countries and the region to deal with the resistance.
To enhance surveillance systems
To strengthen infection control
To strengthen diagnostics techniques for TB and share expertise
To encourage the pharmaceutical industry to develop new drugs and diagnostics techniques for effective

TB treatment and rapid diagnostics.

To develop a preparedness plan on XDR TB within Member States and at regional level to deal with the challenge
Mandated the TB experts and programme managers to meet as a matter of urgency before the end of the year
To mandate SADC officials to attend the forthcoming XDR TB meeting scheduled between WHO and the SA Minister and to be held as soon as possible.
To mandate SADC Secretariat based in Botswana to coordinate information sharing within the region.

In conclusion, a SADC regional approach to the management of XDR TB must be effected and regional cooperation and sharing of information between countries must also continue.

Contact:
SADC spokesperson Lebo Lebese @ 082 467 8496 or,
SA Department of Health's Media Liaison Officer, Charity Bhengu @ 082 679 7424