Ladies and Gentlemen;
Welcome to this very important NEPAD side event focusing on the fight against Tuberculosis and Occupational Lung Diseases, especially in the mining industry in Africa. I am sincerely grateful that you found time to join us to learn more on what NEPAD Agency is implementing to roll back the burden of TB in Africa.
As you are aware, Africa is blessed with abundant natural resources that range from water, minerals, gas and oil, forests, animals and arable land to support agriculture. Since the dawn of the global industrial revolution, natural resources in Africa have formed a bedrock and contributed raw materials that have not only enhanced global development, but facilitated innovation and have become a source of livelihood for local people. In 2016, minerals and metals contributed 20% of Africa’s total Gross Domestic Product (GDP), as a direct investment in to the growth of the economies of African countries.
However, the blessing of these natural resources come at a price to the African continent as a source of conflict, an occupational health hazard to the mine workers and also a source of health risks to the surrounding communities. History teaches us that Africa has paid a heavy price in the past through trade-offs that have resulted in the exploitation of these natural resources at the expense of the health and well-being of indigenous people, and to a certain extent the development of the communities. The mining industry is particularly vulnerable, and the health of mine workers in the poorest countries of the world, particularly in Africa, has for a long time been a subject relegated to being just a “footnote” in interventions to improve occupational health and safety in the mines and other sectors. The nature of mining activities put miner workers at a higher risk of contracting Tuberculosis and other occupational lung diseases. Mine workers risk their health to produce the wealth that comes from the mines and we have a responsibility to look after them.
Ladies and gentlemen, Africa harbours 16 of the 30 high TB burden countries in the world as defined by the Word Health Organisation (WHO). The continent also accounts for 34% of TB deaths annually. The adoption of the Sustainable Development Goal (SDG) 3, and the African Union Catalytic Framework To End AIDS, TB and malaria by 2030 present a new era in the fight against TB. However, if Africa is to win the war against TB by 2030, there is urgent need to streamline efforts to target TB, as well as occupational lung diseases where it matters most, and that is in the vulnerable communities and hot spots for the spread of the disease (i.e. mining communities, transport corridors, correctional facilities, migrants and refugees). Furthermore, this fight against the scourge of TB and occupational lung diseases in Africa rests heavily on the continent’s response in accelerating a multi-sectoral, inter-disciplinary approach involving departments responsible for mining, industrial development, labour and health; private sector; current and ex-mine workers as well as civil society organizations.
Ladies and gentlemen, allow me to emphasize a very important point regarding the policy frameworks both at global and continental level on ending TB. The targets we have set for ourselves are achievable, we can eliminate TB by 2030 but at the same time we have to be very vigilant to sustain current efforts and galvanise renewed commitment to eliminate the disease without fail. Without renewed commitment and political will to support initiatives to eliminate TB by 2030, our efforts will be compromised.
Ladies and gentlemen, let me highlight three (3) approaches that will help to improve the delivery of TB and occupational lung disease services in Africa. Sustainability of these three initiatives is key to ending the burden of TB in Africa by 2030 through systematic identification of current bottlenecks and finding practical solutions to the challenges.
- Increasing case detection and treatment
Firstly, TB cannot be treated unless it has been detected. Introducing innovative means of TB case detection, and treatment is key in ending the pandemic. In order to achieve this we have to increase coverage of TB services by taking the facilities to the most vulnerable communities. NEPAD Agency is working with the Kingdom of Lesotho to set up Digital Mobile X-rays to increase TB coverage in the vulnerable, neglected communities. The Digital Mobile X-rays will move around the vulnerable communities at regular intervals to diagnose TB and initiate the right treatment or refer the patients to the nearest hospital. In addition, countries must also prevent the spread of TB and lung diseases by investing in appropriate protective equipment to protect service providers and workers from exposure. The importance of prevention cannot be over emphasized because it is the most cost effective way of dealing with diseases.
- Accelerating innovative research and development
Secondly, ladies and gentlemen, efforts to tackling the burden of TB are better implemented through evidence-based approaches. Now is the time to pull resources together to invest in research and provide incentives to scientists to find innovative regimens that will reduce the treatment time for TB from the current 18 months to only 3 months. This will not only ensure that the disease is effectively treated but also make it possible for those affected by the disease to return to work in the shortest period of time to contribute to the development of Africa. Some of the patients affected by TB and occupational lung diseases are breadwinners in their families so getting them back to good health quickly will have a ripple effect on family members and dependents. Development cannot occur without a healthy and productive workforce and we have a responsibility of making this a possibility.
In addition to effective research and development, TB knows no borders so tackling it is no longer a national issue, but also a regional one and approaches must realign accordingly to strengthen African health systems. Therefore, TB and occupational lung diseases will not be eliminated by operating in silos, there is need to embrace and promote approaches that encourage regional knowledge sharing through learning and exchange of best practices to tackle the burden of TB collectively. For example, in Southern Africa there exists an influx of mine workers across borders in search of employment and better opportunities. Therefore, we have to accelerate cross-border surveillance and trace these vulnerable group of mine workers to ensure they are diagnosed and where the disease is detected the right treatment should be prescribed. There is need to strengthen regional capacity to manage the burden of TB and put in place disease surveillance systems across countries to enhance diagnosis, detection and treatment of TB beyond geographical boundaries.
- Increase financing to tackle the scourge of TB
Health financing to tackle the scourge of TB still falls behind that of HIV/AIDs and malaria. According to WHO, there is currently a funding gap of 37% amounting to approximately USD 2 Billion to effectively tackle the burden of TB in Africa. In the 25 High Burden TB countries outside the BRICs, international funding accounts for 75% with local funding at 25%. Therefore, we have to implement business plans and come up with strategies to mobilize local resources so that we intensify efforts to end TB by 2030 and ensure sustainability. We have to be able to engage African countries to put in more resources to fill the funding gap, but at the same time lobby our partners for more financial support.
If the above three initiatives can be effectively implemented and coordinated, I can guarantee that TB will be eliminated even before 2030. We have to sustain current efforts, renew commitment to increase coverage of TB services in the most vulnerable communities, while at the same time focusing on preventive measures and taking in to account occupational health and safety issues.
Furthermore, innovative TB research and development has to be accelerated to achieve effective treatment (short time and less dosage). I encourage all the partners to re-assess their financial support towards efforts to end TB by 2030 and evaluate resource mobilization techniques to increase the financial support towards regional approaches to tackling the scourge of TB in Africa.
Ladies and gentlemen, I thank you all for listening.