Health department takes charge in quest for global TB vaccine in SA
Motsoaledi was giving the keynote address at a national workshop in Sandton on Wednesday on the creation of a TB vaccine for children and adults.
'This is a beginning of a new chapter where prevention of TB through vaccination will become the order of the day and a groundbreaking innovation,' Motsoaledi said.
The workshop was hosted by the department of health in partnership with the World Health Organisation (WHO).
'For over 100 years, we have relied on the BCG vaccine to protect our children from TB. But we have not had a tool that can protect adolescents and adults', he said.
Motsoaledi said the day when an announcement is made on the availability of the vaccine will be a revolutionary and would be like freedom from slavery for citizens.
'The slavery of poverty, which is exacerbated by tuberculosis, premature death of young adults, people losing jobs because of tuberculosis, will come to an end', he said.
Motsoaledi emphasised that the key areas that will make the system ready for implementation and rollout of the vaccine will be generating evidence for policy and investments, reliable delivery systems, and production and supply of the TB vaccine.
'These new vaccines will be a game changer for prevention and for reducing the need for TB preventive treatment in health systems', he said.
Motsoaledi said the advent of Covid-19 taught the world when urgency met preparation.
'We saw how vaccines could be developed, approved and distributed at record speed but we also learnt that science alone is not enough. Public trust, strong systems, clear communication and equitable access are just as essential,' Motsoaledi said.
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Daily Maverick
43 minutes ago
- Daily Maverick
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Daily Maverick
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- Daily Maverick
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Mail & Guardian
a day ago
- Mail & Guardian
Most people on ARVs stay on them. Does our health system know that?
How can data help the health department make the most of the R622 million extra it received for South Africa's HIV treatment programme? (Flickr) More than two weeks ago, Health Minister Aaron Motsoaledi About This extra budget is just over a fifth of the roughly So, how to get the best bang for these limited bucks — especially with the health department wanting to get By getting really serious about giving people more than one way of getting their repeat prescriptions for antiretroviral (ARV) medicine (so-called differentiated service delivery), said Kate Rees, co-chair of the A big part of South Africa's problem in getting 95% of people who know they have HIV on ARVs (the second target of the UN's 95-95-95 set of cascading goals) is that people — sometimes repeatedly — For the UN goals to be reached, South Africa needs to have 95% of people diagnosed with HIV, on treatment. Right now, the health department says, But the way many health facilities are run makes the system too rigid to accommodate real-life stop and start behaviour, says Rees. This not only means that extra time and money are spent every time someone seemingly drops out of line and then comes back in, but also makes people unwilling to get back on board because the process is so inconvenient and unwelcoming, she says. Rees and Wilkinson were co-authors of a Journal of the International Aids Society in 2024, of which the results helped the health department 'We often have excellent guidelines in place, built on solid scientific evidence,' says Rees, 'but they're not necessarily implemented well on the ground.' To make sure we track the second 95 of the UN goals accurately, we need a health system that acknowledges people will come late to collect their treatment and sometimes miss appointments. This doesn't necessarily mean they've stopped their treatment; rather that how they take and collect their treatment changes over time. The standard ways in which the public health system works mostly doesn't provide the type of support these patients need, as the resources required to provide such support is not available,' explains Yogan Pillay, the health department's former deputy director general for HIV and now the head of HIV delivery at the Gates Foundation. 'But with AI-supported digital health solutions and the high penetration of mobile phones, such support can now — and should be — be provided at low cost and without the need to hire additional human resources.' We dive into the numbers to see what the study showed — and what they can teach us about making the system for HIV treatment more flexible. Does late = stopped? Not necessarily. Data from three health facilities in Johannesburg that the researchers tracked, showed that of the 2 342 people who came back to care after missing a clinic appointment for collection medication or a health check, 72% — almost three-quarters — showed up within 28 days of the planned date. In fact, most (65%) weren't more than two weeks late. Of those who showed up at their clinic more than four weeks after they were due, 13% made it within 90 days (12 weeks). Only one in 14 people in the study came back later than this, a period by which the health department would have recorded them as The data for the study was collected in the second half of 2022, and at the time 'But it's important to distinguish between showing up late and interrupting treatment,' notes Rees. Just because someone was late for their appointment doesn't necessarily mean they stopped taking their medication. Many people in the study said they either still had pills on hand or managed to get some, despite not showing up for their schedule collection. Sending back a parcel of uncollected medicine after just two weeks — as was the case at the time of the study — would therefore add an unnecessary admin load and cost into the system. ( Does late = unwell? Not always. In fact, seven out of 10 people who collected their next batch of medication four weeks or more late had no worrying signs, such as possible symptoms of tuberculosis, high blood pressure, weight loss or a Moreover, given the large number of people without worrying health signs in the group for whom data was available, it's possible that many of those in the group with incomplete data were well too. When the researchers looked at the patients' last viral load results on file (some more than 12 months ago at the time of returning to the clinic), 71% had fewer than 1 000 copies/mL in their blood. A viral count of <1 000 copies/mL tells a health worker that the medicine is keeping most of the virus from replicating. It is usually a sign of someone being diligent about taking their pills and managing their condition well. Yet clinic staff often assume that people who collect their medicine late are not good at taking their pills regularly, and so they get routed to extra counselling about staying on the programme. 'Most people don't need more adherence counselling; they need more convenience,' says Rees. Offering services that aren't necessary because of an inflexible process wastes resources, she explains — something a system under pressure can ill afford. Says Rees: 'With funding in crisis, we really have to prioritise [where money is spent].' Does late = indifferent? Rarely. Close to three-quarters of people who turned up four weeks or more after their scheduled medicine collection date said they had missed their appointment because of travelling, work commitments or family obligations. Only about a quarter of the sample missed their appointment because they forgot, misplaced their clinic card or for some other reason that would suggest they weren't managing their condition well. Part of making cost-effective decisions about how to use budgets best is to offer differentiated care', meaning that 'not every patient coming back after a missed appointment is treated the same way', says Rees. Health workers should look at how much the appointment date was missed as well as a patient's health status to decide what service they need, she explains. Giving people who've been managing their condition well enough medicine to last them six months at a time can go a long way, Wilkinson told Bhekisisa 's Health Beat team According to the health department South Africa will start rolling out six-month dispensing in August. 'But not everyone wants this,' explained Wilkinson, pointing out that experiences from other countries show that 50% to 60% of people choose six-monthly pick-ups. It speaks to tailoring service delivery to patients' needs, says Rees, rather than enforcing a one-size-fits-all system when more than one size is needed. Says Rees: 'Facing funding constraints, we really need tailored service delivery to keep the [HIV treatment] programme where it is.' This story was produced by the . Sign up for the .
