Address by Honourable Damian Greaves on the occasion of World Tuberculosis Day - March 24, 2003
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It is indeed a pleasure and honour for me to speak to you on some important developments in the areas of health and health care in this country of ours. We at the Ministry of Health, Human Services and Family Affairs remain committed to providing you with improved quality of care and to ensure that every resident of this country is so apprised on the current health status of the population.

Today, I speak to you with specific reference to the annual observance of World Tuberculosis Day, an initiative of the World Health Organization (WHO), commemorated on March 24. World TB Day was established to play a crucial role in increasing the awareness of various stakeholders on the symptoms, diagnosis and treatment of TB, and the importance of effective TB control.

The theme selected for World TB Day 2003 is "People with TB" and the slogan is "DOTS cured me - It will cure you too". DOTS in this context is the acronym for the treatment regime referred to as the Direct Observed Therapy Short-course. The theme was chosen from over 100 entries submitted for consideration from many sources—health and community care workers, doctors, non-governmental organizations and others with interest in TB.

This theme is designed to firstly, emphasize the role of people with TB and cured patients in DOTS expansion and more specifically, in increasing case detection. Secondly, it anticipates an increase in awareness about the implications of TB, especially on the economy, and the fact that there is no excuse for inaction in the face of an available, cost-effective cure. Thirdly, we expect to mobilize TB sufferers to avail themselves of the opportunity of greater access to DOTS treatment, thereby enabling them to become productive members of their society.

The recommended DOTS treatment strategy cures patients, saves lives, prevents the spread of drug resistance and reduces disease transmission. Yet, according to WHO estimates based on 2001 data, only 30% of active TB cases are being diagnosed and treated under DOTS programs. TB is treated through DOTS (Directly Observed Therapy Short-course). The client has to go to the health centre to take his or her medication. The nurse has to witness the client swallow the medication. Accelerating case detection is therefore critical. Preliminary estimates of 2001 data indicate that less than 1 in 3 TB cases are being detected and treated under DOTS.

The situation in Saint Lucia is not so different from the rest of the world. Reports from the Epidemiology Unit of the Ministry of Health, Human Services and Family Affairs are that progress in TB control accelerated slightly between 1997 and 2000. Although progress was below par in 2001 and 2002, there were increases in the number of diagnosed tuberculosis patients: 43% of these patients were relapses. If we are to reach the global targets of 70% case detection and 85% cure rates for those detected by 2005 in order to halve TB prevalence and deaths by 2010, then dramatic increases in case detection and complete treatment, and I emphasize, complete treatment will be needed.

My ministry has understood the importance of reducing the prevalence of TB in Saint Lucia and it is for this reason that it has put together a National TB Control Committee. This Committee since 2000 has been working assiduously towards the provision of complete cure for all TB patients in Saint Lucia.

We also recognize that to achieve this goal all persons who have been diagnosed must undergo the needed treatment and that may be costly. This government as a matter of policy will continue to provide free of charge, all treatment necessary throughout the duration of the therapy. In 2002, twenty-three cases were notified and put on treatment. Of the persons on treatment, 17% have been cured and a further 33% have completed treatment, thus a 50% success rate.

The National Tuberculosis Management Committee has a programme in place to reinforce surveillance, especially in case investigations to reduce the incidence of New and Relapse cases.

Education, One-on-One training, particularly of health workers involved in the programme is included and increased awareness in the community.

Supervision and screening of high-risk groups is an activity that will be introduced to the programme as an objective for 2003. These programme initiatives also have the potential to significantly increase case detection rates through education, awareness-building and social mobilization. We expect to increase the impact of our activities by extending a focused Stop TB campaign beyond World TB Day to the rest of the year.

The objectives for the 2003 communications campaign are to:
1. Educate the general public on the symptoms and treatment of TB;
2. Encourage people to get tested if they have symptoms of TB; and
3. Persuade people to comply fully with the DOTS treatment strategy.

I would like to sincerely thank the members of the National TB Committee and those persons who continue to administer care for the outstanding effort to end the scourge of TB in Saint Lucia.

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