Alice Tembe, CNS Correspondent, Swaziland
In September 2015 at the United Nations General Assembly, the global leadership marked the historic adoption of the Sustainable Development Goals (SDGs) 2030, which replaced the Millennium Development Goals. The 3rd Goal within these 17 SDGs specifically targets the global epidemics of HIV-AIDS, TB, malaria and neglected tropical diseases and commits to end these epidemics by the year 2030. It has been a year since this commitment and there have been notable successes. However, it is still a few years to 2030 and there is still work to be done.
HIV & AIDS Indications
On the 4th of April 2016, the Executive Director of the Swaziland Emergency Response Council (NERCHA), Mr. Khanya Mabuza noted in an interview with the Times of Swaziland that the HIV infections are down by 50% in Swaziland. This news came with very encouraging statistics, including that while the country once recorded 14,000 AIDS related deaths per year, this figure has now dropped to 3209. New infections have dropped from about 17000 each year to 9,839. While these numbers indicate great strides in reducing higher chances of TB and in minimizing development of drug resistant TB (MDR-TB), there is still increasing concerns evidenced by the fact of about 4% of girls aged 18-19 years getting infected with HIV by partners who are 8 years older than them. An increasing number of the new infections are happening in this younger age group. It has also been reported that patients collecting antiretrovirals (ARVs) at the national Mbabane Government Referral Hospital are throwing away their medication packages before they leave the hospital. This flags that there is still a lot of stigma and fear of discrimination by people living with HIV (PLHIV).
TB Indications
In May 2016, the World Health Organization endorsed a new shortened treatment regimen for MDR-TB. This new 9-12 month treatment is substantially shorter and easier to tolerate than the previous 24-month regimen. In order for the new regimen to reach patients in need, countries must now adopt this regimen into their national guidelines, train health workers to deliver the new regimen, and ensure that adequate supplies of quality-assured medicines are available. It is disheartening to note that most of the TB high burden countries will be at the tail-end of this process. However, as Dr Anna Nakanwagi-Mukwaya, Country Director in Uganda with the International Union against Tuberculosis and Lung Disease (The Union) expressed, all these great and innovative approaches and investments are hitting a solid wall of failing health systems, over-stretched healthcare workers, partial political commitment and dwindling health education funding. Most funding for health initiatives comes in silos and yet all the investment will need to utilize the one health system in the country and the same health care workers. Indicatively, most strides that could have been achieved have not been due to this challenge.
Malaria Indications
According to Erika Larson, from the University of California San Francisco, Swaziland is likely to be first to eliminate malaria in Southern Africa (https://www.ucsf.edu/news/2015/11/328181/swaziland-likely-be-first-eliminate-malaria-southern-africa). She further explained that Swaziland malaria cases decreased by 99% between 2000 and 2014. In the period between July 2015 and June 2016, there were only 603 cases of malaria. This is indicative of the high probability of elimination of local malaria cases by end of 2016 in Swaziland. These sentiments were shared at the Malaria Elimination Group’s 10th meeting led by Swaziland’s Minister of Health, Honorable Sibongile Ndlela-Simelane in November 2015.
Conclusion
These are just but few indications that while there are some large and effective interventions that are moving fast towards achieving the SDGs milestones targeted for 2030, a lot of work till remains to be done. Acknowledging that the state and prevalence of HIV correlates with the prevalence of TB and more so with MDR-TB, it is therefore essential for the following to be of cognizance:
Alice Tembe, Citizen News Service - CNS
September 10, 2016
HIV & AIDS Indications
On the 4th of April 2016, the Executive Director of the Swaziland Emergency Response Council (NERCHA), Mr. Khanya Mabuza noted in an interview with the Times of Swaziland that the HIV infections are down by 50% in Swaziland. This news came with very encouraging statistics, including that while the country once recorded 14,000 AIDS related deaths per year, this figure has now dropped to 3209. New infections have dropped from about 17000 each year to 9,839. While these numbers indicate great strides in reducing higher chances of TB and in minimizing development of drug resistant TB (MDR-TB), there is still increasing concerns evidenced by the fact of about 4% of girls aged 18-19 years getting infected with HIV by partners who are 8 years older than them. An increasing number of the new infections are happening in this younger age group. It has also been reported that patients collecting antiretrovirals (ARVs) at the national Mbabane Government Referral Hospital are throwing away their medication packages before they leave the hospital. This flags that there is still a lot of stigma and fear of discrimination by people living with HIV (PLHIV).
TB Indications
In May 2016, the World Health Organization endorsed a new shortened treatment regimen for MDR-TB. This new 9-12 month treatment is substantially shorter and easier to tolerate than the previous 24-month regimen. In order for the new regimen to reach patients in need, countries must now adopt this regimen into their national guidelines, train health workers to deliver the new regimen, and ensure that adequate supplies of quality-assured medicines are available. It is disheartening to note that most of the TB high burden countries will be at the tail-end of this process. However, as Dr Anna Nakanwagi-Mukwaya, Country Director in Uganda with the International Union against Tuberculosis and Lung Disease (The Union) expressed, all these great and innovative approaches and investments are hitting a solid wall of failing health systems, over-stretched healthcare workers, partial political commitment and dwindling health education funding. Most funding for health initiatives comes in silos and yet all the investment will need to utilize the one health system in the country and the same health care workers. Indicatively, most strides that could have been achieved have not been due to this challenge.
Malaria Indications
According to Erika Larson, from the University of California San Francisco, Swaziland is likely to be first to eliminate malaria in Southern Africa (https://www.ucsf.edu/news/2015/11/328181/swaziland-likely-be-first-eliminate-malaria-southern-africa). She further explained that Swaziland malaria cases decreased by 99% between 2000 and 2014. In the period between July 2015 and June 2016, there were only 603 cases of malaria. This is indicative of the high probability of elimination of local malaria cases by end of 2016 in Swaziland. These sentiments were shared at the Malaria Elimination Group’s 10th meeting led by Swaziland’s Minister of Health, Honorable Sibongile Ndlela-Simelane in November 2015.
Conclusion
These are just but few indications that while there are some large and effective interventions that are moving fast towards achieving the SDGs milestones targeted for 2030, a lot of work till remains to be done. Acknowledging that the state and prevalence of HIV correlates with the prevalence of TB and more so with MDR-TB, it is therefore essential for the following to be of cognizance:
- Unwavering political support by all governments towards the SDGs commitments and interventions deigned to achieve them
- Consolidating funding targeted not on one disease or epidemic but at enhancing the overall health delivery system.
- Investing in increasing and retaining healthcare professionals to ensure that all the great interventions have enough human resource backing.
- Establishing mechanisms for affordability of quality and effective drugs to reach the high burden countries which usually are the poorest.
- Increasing collaboration of health programmes towards elimination of duplicate health systems, human capital and financial resources
Alice Tembe, Citizen News Service - CNS
September 10, 2016
