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Legislators tackle TB scourge

by Lesotho Times
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Limpho Sello

LEGISLATORS have established a caucus to fight the deadly tuberculosis disease by strengthening accountability in health financing and ensuring an effective implementation of preventive and treatment programmes throughout the country.

The legislative caucus is made up of 21 members mainly drawn from the portfolio committee on social cluster and three others from other portfolio committees.

Member of parliament for Mabote Constituency, who is also the chairperson of the portfolio committee on social cluster, Fako Moshoeshoe, said they would invest their time and energy in the fight against the scourge which is one of the country’s major killers.

“Together with our partners, we would like to ensure that by 2030 people will no longer die of tuberculosis,” Mr Moshoeshoe said, adding, “We are passionate about this mission because tuberculosis is preventable and curable”.

He said there was need for advocacy for behaviour change, enforcing preventive measures and ensuring there was early detection of the disease.

He said the TB legislative caucus had already identified approaches and platforms for advocacy on reforms in health financing with specific focus on tuberculosis and reduction of the cost of care.

“We will lobby the government to introduce a National Health Insurance, in addition to strengthening its inclusive approach by enhancing collaborative activities with key stakeholders including non-governmental organisations (NGOs) and the private sector. This will help to improve social accountability to ensure that we achieve more with limited resources,” Mr Moshoeshoe said.

The legislative caucus also intends to advocate for the development and implementation of a sustainable public financing model.

Mr Moshoeshoe further said the group would organise an induction programme for all parliamentarians, community leaders and school authorities to equip them to champion the fight against TB  within their spheres of influence.

Meanwhile, the United States (US) Ambassador to Lesotho, Rebecca Gonzales, says that Lesotho remains a high burden TB country with  an estimated 16 000 new TB cases annually.

She said this was despite the country having enough GeneXpert machines that are used to diagnose TB.

Ms Gonzales said this at the recent World TB Day commemorations which were held in Maseru under the theme ‘Wanted: Leaders for a TB Free World. You can make history-End TB.’

The day is commemorated every year on 24 March to reflect on the progress of the fight against the disease.

Ms Gonzales said that although Lesotho had enough diagnostic machines, they were however, under-utilised due to the lack of cartridges and maintenance agreements.

“Lesotho currently has the sufficient GeneXpert machines to diagnose all suspected cases of TB. However due to the lack of cartridges, a lack of maintenance agreements, and limited staff in laboratories, these diagnostic machines are not being optimally utilised,” Ms Gonzales said.

Ms Gonzales said out of the 16 000 new TB cases every year, 75 percent were estimated to be co-infected with HIV. She added that TB is the leading cause of death among individuals living with HIV, accounting for one in three HIV-related deaths in 2016.

She nonetheless noted that long term collaborations between Lesotho and her government and its partners had resulted in major strides.

“Ninety nine percent of the registered TB patients now know their status while 90 percent of the registered TB and HIV co-infected patients are on antiretroviral treatment (ART). I am proud that the US government has been a strong partner with Lesotho in the fight against TB because it means that together we are saving lives.

“However, despite these accomplishments, there is still much more to do in Lesotho to control TB. Overall, Lesotho still has a high burden of the disease,” Ms Gonzales said.

She said the mortality rate remained high at approximately 15 percent due to late diagnosis while 4.8 percent of the new cases were drug resistant.

Ms Gonzales said the scale up of Isoniazid Preventive therapy (IPT) among people living with HIV has been well below expectations as only about 25 percent of those eligible have received this intervention.

“So, what can be done to turn his situation around? Let me focus on the three I’s: Intensified case finding, IPT, and infection control. For each of these, we have interventions that are currently under-utilised.”

She said IPT was an effective and low-cost way to prevent TB disease in persons living with HIV but due to persistent shortages of isonicotinylhydrazide (an antibiotic) and Vitamin B6 too many Basotho were not receiving the benefits of this intervention.

“We need to address the supply chain issues that have resulted in these stockouts. Just as we would not accept stockouts of first line antiretroviral drugs, we cannot accept stockouts of INH and B6 at National Drug Services Organisation (NDSO). IPT is a life-saving intervention that should be available to all eligible persons living with HIV.”

She said often TB transmissions also occurred within health facilities affecting both patients and staff and there was a need to achieve zero infection in the health centres.

“These facilities are meant are meant to help people become well, not make them ill.”

For his part, Deputy Prime Minister, Monyane Moleleki, said the implementation of working strategies needs to start immediately to ensure that Lesotho achieves its target to end TB by 2030.

Mr Moleleki said the government has to ensure that prices of treatment are lowered.

“We have more than 200 000 known patients of TB so something needs to be done.

“It is not only the Health ministry’s responsibility but everyone’s to ensure that we tackle TB. I am told that we are second in the world among 30 high TB burden countries,” Mr Moleleki said.


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