Tuberculosis: South Africa's Killer
South Africa is facing an enormous battle against tuberculosis, the country’s leading cause of death. Many tuberculosis patients in this area of the world suffer from malnutrition, poverty, and unstable living conditions. Without a healthy and secure lifestyle to boost their health, many South Africans are at risk of contracting tuberculosis.
Tuberculosis is an extremely difficult disease to combat because there are multiple virulent, drug-resistant strains of TB circulating throughout the population. There is multi-drug resistant TB (MDR-TB) as well as extensively drug-resistant TB (XDR-TB), which is virtually incurable. MDR-TB is easily transmitted through the air – nearly 80% of all MDR-TB cases are caused by breathing in the virus from an infected person.
The multiple drug-resistant strains of tuberculosis make it a deadly disease of the poor, as it thrives in dirty, impoverished communities. Those infected with HIV/AIDS are at much higher risk of contracting tuberculosis, and because South Africa has one of the highest HIV-infected populations worldwide, many people here contract and die from tuberculosis. In 2011, tuberculosis was responsible for 1 in 10 deaths and killed approximately 54,100 people country-wide. WHO statistics show that nearly 80% of young adults in this region are infected with tuberculosis and every year, 1% of the population develops TB. This is the third highest tuberculosis rate worldwide, falling behind India and China.
Bongie Ndlovu is a 39 year old woman living in an impoverished settlement just south of Johannesburg. Her living conditions are abysmal – she and her neighbors reside in shacks surrounded by rotting garbage, and the shacks are damp, dark and poorly ventilated. Due to her cramped and filthy living spaces, she contracted tuberculosis. In an interview with Voice of Africa, she described the perils of living in cramped, dirty conditions: "Many people here will tell you they do not have TB, but you will see it if you look carefully. They are sick because of the filthy living conditions.”
Currently, only old fashioned and ineffective treatments are available for South African patients. However, they are highly inconvenient and uncomfortable for TB patients – injections must be injected for months and handfuls of expensive pills need to be taken on a daily basis for up to two years. The current TB treatments have serious side effects such as deafness, psychosis and severe nausea. They also have low treatment rates – more than half of the multidrug-resistant TB patients on treatment will die. On average, only 13% of XDR-TB patients are cured in South Africa.
Only one new drug has been approved for use against TB in the past 50 years. Drug patents and arduous approval processes create enormous delays in providing proper medicine to patients in South Africa. There are two new promising drugs for drug-resistant TB, but they are not yet widely available in South Africa due to drug patents. One of the drugs, linezolid, offers an 87% success rate in curing its patients. However, it is owned by Pzifer, meaning that medical organizations such as Doctor Without Borders must pay $65 per tablet per day if they want to provide their South African patients with linezolid. In total, it costs approximately $11,300 per patient for 6 months of treatment, but other patients must take it for 18 months. This cost is unrealistic and unacceptable for humanitarian organizations trying to help South Africans sick with tuberculosis.
More resources need to be poured into South Africa’s ubiquitous and impoverished communities in order to improve healthcare access and create sanitary living conditions. Poverty plays an enormous factor in public health issues such as tuberculosis, and it is imperative that the government focus on how to give the poor wider access to tuberculosis treatment centers as well as create more sanitary living conditions. There also must be a strong imperative to implement policies and reform on the ground, because for all the talk of battling tuberculosis, the government has failed to make significant progress in lowering its tuberculosis-infected population.
