Stop TB Partnership

Collaborating to deliver best-practice education for the management of multidrug-resistant tuberculosis in South Africa

25 March 2015 - South Africa - The South African Department of Health (DoH) hosted an innovative workshop on the introduction of new agents in the management of multidrug-resistant tuberculosis (MDR-TB) from 9 - 13 February 2015, led by Dr. Norbert Ndjeka, Director of Drug-Resistant TB (DR-TB), TB and HIV. The workshop was delivered by a collaboration of South Africa’s National TB Programme, the International Union Against Tuberculosis and Lung Disease (The Union) and supported by an educational grant from Janssen. The workshop was also consistent with the goals of the Janssen Global Public Health (GPH) unit, which seeks to create and implement innovative strategies to improve access to medicines, foster collaboration with key global health partners and support public health policies and technical solutions that address critical health needs in highly burdened communities.

Healthcare professionals responsible for management of DR-TB across South Africa’s nine provinces were represented at the event, including physicians, clinical managers, pharmacists, laboratory staff, provincial managers responsible for DR-TB and national department of health representatives. The training was part of a pioneering programme to address the growing challenge of DR-TB in South Africa.

"The introduction of new medicines to treat tuberculosis is very exciting. We are very happy to be part of this global effort. It reminds me of the introduction of antiretroviral therapy in the public sector in South Africa during the year 2004. We were very excited and nervous at the same time," said Dr. Norbert Ndjeka, Director of Drug-Resistant TB, TB and HIV.

South Africa is the first country to develop a national framework for introduction of new medicines for treatment of DR-TB in compliance with the World Health Organization (WHO) guidelines for the programmatic management of the disease. Guidance on the implementation of this national framework was a key focus of the day, to support its delivery and ensure the most effective management of these vulnerable patients. The Lead Facilitator of the workshop was Professor Jose Caminero, Head of DR-TB under The Union, who’s also a Global Scientific Authority in TB, with a focus in DR-TB. Professor Caminero presented an overview of TB management before focusing on new medicines including SIRTURO®, linezolid and delamanid.

Dr. Ndjeka remarked that the introduction of new medicines is an opportunity for us to improve on overall programmatic management of DR-TB, including our pharmacovigilance. This is an opportunity to improve patients’ treatment outcomes.

Following the South African approval in October 2014 of SIRTURO® for the management of HIV-negative or HIV-infected, ART naïve adult patients who have laboratory confirmed MDR-TB, education was provided on appropriate use of this treatment. Containing the spread of drug resistance in TB is a high priority and the appropriate selection of patients and their subsequent management to support compliance with treatments are key factors in this containment.

Healthcare professionals in attendance were trained as trainers themselves to roll-out the workshop locally, which will extend the reach of this knowledge and ensure frontline staff in all provinces are up-skilled to deliver the best care in MDR-TB.

South Africa has the third highest TB burden globally, largely driven by a TB and HIV pandemic. Multidrug-resistant TB has gained momentum with more than 15,400 new cases diagnosed in 2012, the highest rates in Africa.

Following what the professionals in attendance deemed to be a hugely productive and successful day, encouraged by the support and direction provided by the South Africa DoH and knowledge of the latest developments in the field, they left with renewed optimism and drive to eradicate the burden of MDR-TB in the country.