Thursday 20th Sep 2018

Our Host, the Premier of KwaZulu-Natal, Mr Willies Mchunu,
Minister of Health, Dr Aaron Motsoaledi
The Chair of the Conference Organising Committee, Dr Margot Uys,
Health MEC in KwaZulu-Natal, Dr Sibongiseni Dhlomo,
United States Chargé d’Affaires, Ms Jessey Lappen,
Executive Director of StopTB Partnership, Dr Lucica Ditiu,
Professor of Respiratory Medicine, Professor Keertan Dheda,
Conference Delegates,
Members of the Media,
Ladies and Gentlemen,
 
Good Evening, and a very warm welcome to the 5th South African TB Conference. 
 
A conference like this, which  is solely dedicated to enhancing our strategies to end TB, can only be described as revolutionary.
 
It is revolutionary because its purpose is solely to lend a hand to humanity and preserve life 
 
While TB is preventable and curable, it remains the leading cause of death in South Africa and this cannot be acceptable to any one of us.
 
According to the World Health Organisation, TB remains among the top ten leading causes of death globally as well. This means that we must do everything possible both here and in every corner of the world to eliminate tuberculosis from the face of the earth .
 
And your zeal, enthusiasm, and participation at this Conference reaffirms our resolve, determination and decisiveness to end TB-related deaths by 2030.
 
We are encouraged because this is a conference that can provide concrete proposals on finding those we are missing in the health system, but who carry TB so they can immediately be put on treatment and cured.
 
It is also a platform that offers us an opportunity to share experiences on what needs to be done to strengthen our health and social systems.
 
We must explore the best ways ofmobilising the human and financial resources to improve health outcomes in informal settlements, in rural villages and in those that are most vulnerable to acquiring TB in our country.
 
This will be  a conference informed not only by the advances in medical research, but also by the growing understanding of the social determinants of TB as well as well as other diseases. These include poverty, unemployment , poor nutrition, overcrowding as well as such issues such as culture, gender, and social stigma that fuel the spread of diseases.
 
This is an important conference for bringing together social partners to speak with one voice on the need to attract investments in TB research, treatment, and for the advancement of health and human rights of people living with TB and HIV .
 
Its importance also lies in finding new TB champions that will advance the prevention revolution - not just against TB transmission, but for the prevention of the spread of HIV as well.
 
It is worth noting that we meet during South Africa’s Youth Month. 
 
To us, this month serves as a reminder of the power of young people as agents of change. It is again in the hands of our youth to be the new revolutionary ambassadors across society, to advance awareness about how to prevent the spread of TB and stop TB and AIDS related deaths.
 
How can we forget that it was the determined and heroic youth of our land,who on the 16th of June 1976 faced the tyranny and might of an oppressive system.
 
In their united action against the indignity and evil of racial oppression, our young people drew a line in the sand and demanded a just society based on human dignity, non-racialism, non-sexism, and democratic governance.
 
Our youth, civil society organisations, our press and the international media exposed the brutality of the regime and the whole world was mobilised to hasten the demise of the apartheid regime.
 
The same determination is called for to make another giant step in our forward march towards ending preventable and treatable infections of TB and HIV. 
 
And so we live in hope that our youth in all corners of our land, will rise again to advance the health and wellbeing of our nation, as we deepen the programme of reconstruction and development.
 
We look to them to work with us to ensure that no one is left behind as we proactively go out to find people infected with TB and put them on treatment.
 
This we know we must do honouring the human rights of those infected with TB – no one should be stigmatised because they have TB. For as long as we breathe,anyone can contract the disease.
 
We look to an activist South African and global press to be our ally in building healthy communities that are free from the pandemics of TB and AIDS. 
 
We look to young artists to dig deep into their creative reservoirs to compose anthems of hope that will mobilise not only South Africans but the world, to lend a hand in ending diseases and improving healthy livelihoods.
 
In a month on which Michael Jackson passed away in 2009, we need artists who, like him, will compose lyrics dedicated to life and the healing of the world for the entire human race.
 
Like him, to end human suffering, poverty,disease and the abuse of women, we must say, “There’s nothing that can’t be done if we raise our voices as one.”
 
So unity and action must be our daily mantra to usher in a world that has a more humane face. 
 
We need to return to the era of universal hope and collective action that raised global consciousness to fight hunger, poverty, and inequality that provides a fertile ground for the spread of diseases.
 
And may this TB Conference again be inspired by a song of hope, care, and love that encourages everyone to lend a hand to life by bringing the TB epidemic to its end. 
 
Let us return to the hope of “We are the World” by the USA for Africa, and from the depth our hearts rekindle the call by those legendary artists who sang in unison that:
 
There comes a time…
When the world must come together as one
There are people dying
So they know that someone cares
And their lives will be stronger and free
As God has shown us by turning stones to bread
And so we all must lend a helping hand


Programme Director,
 
President Ramaphosa has called our nation to action. This call means working together with a singular purpose to ensure that no one is left behind. 
 
Whether in terms of employment and economic prospects, or education or health – we must leave no one behind especially the downtrodden and most vulnerable among us! 
 
This must characterise our new covenant of deep caring and love for all our people across the length and breadth of our land. 
 
Programme Director, 
 
In South Africa and indeed all over the world, on 18th July 2018, we will unite in celebrating the 100th anniversary of the birth of Nelson Rolihlahla Mandela, the founding father of democratic South Africa who survived TB and became a leading campaigner against it. 
 
We also celebrate the life of Mama Albertina Sisulu, who would also have celebrated her 100th birthday. She was a dedicated health worker and political activist who made a significant contribution to the struggle for our liberation. 
 
In memory of these health champions, we call on society and the health profession,to emulate these leaders in everything we do.
 
I am therefore pleased that the theme of this conference is
“Step Up! Let’s embrace all to end TB”
 
This theme talks to our aspirations as reflected in current global imperatives of mobilising all of us, especially leaders, to work towards ending TB by 2030 in line with the United Nations’ Sustainable Development Goals.
 
We  look forward to the upcoming first ever United Nations High Level Meeting on TB, to be held on the side-lines of the United Nations General Assembly on the 26th September 2018. 
 
Our conference therefore, must set the stage for South Africa’s participation in that High Level Meeting to be attended by Heads of State and Government. 
 
Part of what we must do, is to prepare well not only for that meeting but to implement decisions that will be taken at that High Level meeting upon our return. However, we must not wait until September as there are things we must and can do - starting now. 
 
The National Strategic Plan for HIV, TB and STIs 2017-2022, provides a clear roadmap on what needs to be done. 
 
Each sector in our country must step up and do what is needed to end TB.
 
We will not be able to dig ourselves out of the current TB epidemic only with the “pill”, without addressing developmental and underlying social and structural drivers of this disease. 
 
The National Development Plan (NDP) requires that we prioritise creating jobs, building houses and clinics; preparing our children for a world of change and progress; building cities and towns where families can be safe and live happy and productive lives.
 
Whereas these interventions on their own are not sufficient, they are critical if the goal of ending TB by 2030 is to be realised and sustained. 
 
Ladies and Gentlemen,
 
It is an indictment on all of us that the TB epidemic has been allowed to prevail for too long both globally and in our country.Nobody should needlessly die, and definitely, NOT from TB. 
 
We therefore draw inspiration from the bold goals and targets that have been set, including that of ending TB, as espoused in the Sustainable Development Goals and the World Health Organisation. 
 
We have, as a country, adopted the 90-90-90 targets set by the Stop TB Partnership’s Global TB Plan. We are indeed proud that these targets were first advocated for by our very own Minister of Health, Dr. Aaron Motsoaledi.
 
As you know, this requires us to find by 2020 at least 90% of people infected with the TB in the general population; at least 90% of those infected among key populations and vulnerable groups and treat successfully at least 90% of those who are in our treatment programmes.
 
Through government interventions, we are making reasonable progress with treatment success of drug sensitive TB which nationally exceeded 85% in 2016. 
 
In addition, with the introduction of new drugs for the treatment of drug resistant TB, our success rate for the 2015 cohort is just under 70% which is among the best in the world.
 
Where we are struggling a little, is on finding people infected with TB, but not on treatment. These are the so-called missing TB patients! 
 
The Department of Health estimates that annually we are missing about 160 000 patients with TB, which is our country’s contribution to the more than 4 million people globally with TB that are not on treatment. 
 
Undiagnosed TB infected persons,constitute a significant mobile and invisible infectious pool of people that unknowingly spread the disease to others, including children. 
 
Like the rest of the world, we have joined the global effort to find these patients as rapidly as possible. Once found, we will ensure that they are initiated on treatment and successfully treated. 
 
It is our wish that innovative means of finding these missing patients, will be one of our contributions to the High-Level Meeting in September this year. As South Africa, we confirm our participation at a Presidential level. 
 
At that meeting, we will strongly advocate for the endorsement of the following “Key Asks” that will be made to Heads of State. 
 
1. Reaching all people by closing the gaps on TB diagnosis, treatment and prevention;  
2. Transforming the TB response to be equitable, rights-based, and people-centred;
3. Accelerating development of essential new tools to end TB;
4. Investing the necessary funds to end TB; and
5. Committing to decisive and accountable global leadership, including regular reporting and review.
 
Ladies and Gentlemen,
 
There are critical milestones that we have set in our course of action towards that High-Level Meeting and beyond. 
 
For starters, we have engaged with different stakeholders and traditional leadership to actively take part in the fight against TB. We are pleased by their positive response, which culminated in united action during our commemoration of the World TB Day this year here in eThekweni. 
 
Following successful discussions with the Speaker of Parliament, we are pleased to announce that, South Africa’s TB Caucus will be launched ahead of the High-Level Meeting. This formation will energise members of Parliament to also advocate for the end of TB.
 
As announced by the President in the State of the Nation Address in February, we will launch a National Screening and Testing Campaign this year. 
 
We seek to screen and test 14 million people for HIV and TB, and 7 million for high blood pressure and diabetes annually over the next 3 years. 
 
This will help us add an additional 2 million HIV infected persons to the existing 4 million already receiving ARVs by December 2020. The campaign will also contribute to finding the missing 160 000 TB infected persons, especially in TB high burden areas.
 
As chairperson of the South African National AIDS Council, I will convene our own meeting of leaders to reflect on the decisions of the UN High-Level Meeting, and take the necessary action to implement the political declaration adopted by Heads of State and Government. 
 
Our meeting will draw voices from patients, patient advocates, civil society organisations, the private sector, organised employers and organised labour, traditional leaders, and faith-based organisations.
 
Programme Director,
 
All of us gathered here, are the brains trust of our country on TB. Therefore, we must consolidate the learnings from this conference and translate them into an implementable programme of action. 
 
Minister Motsoaledi represented us at the World Health Assembly recently at which he advocated for some very specific actions. These included a point of care diagnostic like the rapid tests that we have for HIV and malaria, and for a treatment regime that is shorter than the current 6 months.
 
His call for investment in research and development for new vaccines, new diagnostics and new medicines, including better diagnostics and medicines for children, present us with new opportunities in our collective effort to end TB. 
 
If we do not invest in research and development now and fail to develop new diagnostics, vaccines and medicines as well as creative ways of dealing with the social determinants of TB transmission, we will not reach our targets. 
 
It is only with new tools that we can achieve a dramatic reduction in new TB infections needed to ensure total elimination of the disease by 2030 or earlier. 
 
And in remembering the international icon of our freedom and a global champion of TB, the late President Nelson Mandela, let us recall his warning in Bangkok in 2004 where he said:
 
“The world has made defeating AIDS a top priority. This is a blessing. But TB remains ignored. Today we are calling on the world to recognize that we can't fight AIDS unless we do much more to fight TB as well.”
 
We must all join hands and ensure that no one is left behind as we intensify our fight to end TB.
 
Every achievement that the world has made in advancing human civilisation, was only possible because of sheer determination in finding solutions to complex challenges of the time. With this fight, it is also possible!
 
Clearly TB as a disease, is the biggest health challenge of our time. Therefore, we are once again called into action. 
 
Let all of us to declare in unison, that:
 
There comes a time…
When the world must come together as one
There are people dying
So they know that someone cares
And their lives will be stronger and free
As God has shown us by turning stones to bread
And so we all must lend a helping hand

 
Standing together and united in action, we can defeat TB! It is thus my privilege and honour to declare the 5th South African TB Conference opened, and I wish you a very productive meeting!

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