WORLD TB DAY

Ministry of Health
March 23, 2006
     
     Excellencies, esteemed guests & colleagues, ladies & gentlemen
    
     First I would like to congratulate the Ministry of Health and Social Welfare for honoring World TB Day, and say that I appreciate the invitation of the Ministry to make these remarks today. I recognize the presence of Ministry of Health and Social Welfare personnel in the room as well as the presence of our valued partner in assistance to Swaziland, the World Health Organization. I also want to acknowledge the hard work and commitment of all of the health care workers throughout the country who daily confront the TB epidemic in Swaziland, and who labor to provide quality care to the nation’s citizens.
    
     The enormity of the TB crisis in Swaziland cannot be overstated. Swaziland, in addition to having the world’s highest adult HIV prevalence rate, also has one of the world’s highest incidence rates of TB and highest rates of TB-HIV co-infection. Persons living with HIV in Swaziland are likely to die of TB unless they are treated. Forms of TB that have become resistant to drugs are now present in Swaziland, making the situation even more dire and alarming. Unfortunately, Swaziland currently has inadequate systems in place to detect and treat cases of TB, in communities and as a nation.
    
     There is no doubt that the potential to turn this situation around exists. Rates of case detection and treatment can improve, and countless Swazi lives can be saved, if the Ministry of Health can continue with its recent efforts to improve and expand the national TB program. The Ministry of Health could also extend and improve the health of its citizens by integrating its TB and HIV/AIDS programs, so that people who are HIV positive can avoid TB infection, and so that people who are TB infected can be encouraged to get tested for HIV.  This is important so that they can receive antiretroviral drugs and prevent or be treated for the other infections that attack the body when HIV weakens the immune system.
    
     Strong leadership, commitment, and management on the part of the Ministry of Health can and will make a difference in avoiding unnecessary illness and death due to TB. This, like the fight against HIV & AIDS, is an emergency situation that needs and deserves an emergency response on the part of the Ministry of Health with strong and vocal support from all other levels of national leadership. 
    
     The United States Government is wholly committed to providing assistance to the Ministry and to the people of Swaziland. Our assistance to the health sector in Swaziland comes through the President’s Emergency Plan for AIDS Relief, the U.S. global effort to prevent HIV infections and to provide care, support, and treatment to people living with HIV/AIDS.
    
     In addition, the United States Government is a major financial contributor to the Global Fund for HIV/AIDS, Tuberculosis, and Malaria. The Global Fund, in turn, contributes significant financial resources to the Ministry of Health and Social Welfare in Swaziland for HIV/AIDS, malaria, and TB. The United States is committed to working to ensure the successful implementation of these Global Fund programs in Swaziland, including the TB grant. 
    
     I am pleased to say that we have recently discussed detailed plans with the Ministry of Health and Social Welfare (in conjunction with the World Health Organization) regarding United States Government’s support, to improve TB and TB/HIV services. These plans include:
    
* Assisting the Ministry in updating the TB clinical guidelines and algorithms
* Assisting the Ministry in expanding access to TB services through provision of training and strengthening referral systems
* Assisting the Ministry in improving access to microscopy through improved transportation and skills enhancement of staff
* Encouraging the participation of local community and church groups in TB control and prevention
* Assisting facilities and health regions in improving the recording and reporting of TB treatment outcomes
* Supporting the implementation of joint TB/HIV committees at all levels
* Assisting in increasing the number of TB patients receiving HIV testing and counseling
* Providing additional technical assistance to ensure the success of the Global Fund TB grant
* Committing a full-time United States Government staff member as well as U.S. implementing partner staff with strong technical and managerial experience in TB programs to be resident in Swaziland. These technical experts will work in collaboration with Ministry and WHO efforts to create a strong, coordinated TB control effort.

     At the end of the day, however, in order for any or all of these efforts to be successful, strong Swazi leadership and focused management efforts are required.

     You can count on the United States to be a resolute partner in one of the most important struggles facing Swaziland. Thank you.