Totally incurable TB-patients in SA pose worldwide health risk

When South Africa’s ex-president Thabo Mbeki closed down funding for the country’s TB-prevention programmes and opened up the borders for mass-migration throughout the African continent, he started a terrible chain of events…

March 24 2013 – This being World Tuberculosis Day, I thought I’d write a brief history about Tuberculosis in South Africa. In 2001, ex-president Thabo Mbeki — in his infinite medical wisdom — decided to close down many of South Africa’s excellent chain of specialist TB-hospitals. He also stopped government-funding of the SA National Tuberculosis Association which raised funds for these hospitals.

Within just a decade, SA moved from preventing TB very adequately before 1994 to spreading it throughout Southern Africa by 2005. During apartheid, the South African National Tuberculosis Association reported that its case load increased from 88,000 cases in 1985 to about 124,000 in 1990: but there was a high-cure rate: with 6,000 people dying on average each year in the early 1990s. In 1994, about 47,800 new cases were reported.  By 2011, the world health organisation reported that SA admitted to 250,000 new TB cases each year.  The ANC-regime ‘s anti-white propaganda now also claims that ‘TB was introduced in South Africa by settlers.” However this is historically inaccurate: the DNA record and the archeological records find evidence of TB in the ancient peoples all over the world, including throughout southern Africa and right up into Egypt.

After 1994, when migration patterns into South Africa became very much heavier: as Mbeki  switched control of the borders from the defence force -  which had medical units with infectious-control experts on call -  to the far less well-equipped SA police. And the pre-1994 border-control screening for TB and other infectious diseases amongst foreign immigrants – which was routine for foreign workers during apartheid – was completely dropped.

Zuma also closes down TB-hospitals:

Now the country is foremost in the world with what is referred to as a high TB burden…  And it’s also one of four countries in the world where the most drug-resistant strain of Tuberculosis mankind has yet to wage war against is now also being identified. Mbeki’s disastrous decision continues under the Zuma-cabinet: another three TB-hospitals in Gauteng were closed down ‘to channel resources to where they are needed most’. The Gauteng Department of Health and Social Development closed down the Charles Hurwitz TB Hospital in Soweto, the Tshepong TB Hospital in Pretoria and the East Rand TB Hospital in Ekurhuleni last month.   http://allafrica.com/stories/201010070580.html

• Study in Emerging Infectious Diseases Journal, March 2013: http://wwwnc.cdc.gov/eid/article/19/3/12-0246_article.htm
• Current study March 22 2013 article by Wilma Stassen:    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958014/                   
• Doctors struggling Totally Drug Resistant Tuberculosis in South Africa: http://www.usnews.com/news/articles/2013/02/11/doctors-struggling-totally-drug-resistant-tuberculosis-south-africa
• Previous study by Prof Thomas Victor et al: Feb 10 2010: http://www.iol.co.za/scitech/science/news/study-identifies-new-strain-of-resistant-tb-1.1490391
• Contact Prof Thomas Victor, Dept Biomedical Sciences, molecular biology and human genetics: email tv@sun.ac.za tv@sun.ac.za  portal:  http://sun025.sun.ac.za/portal/page/portal/Health_Sciences/English/Departments/Biomedical_Sciences/MOLECULAR_BIOLOGY_AND_GENETICS/General
• Three more TB hospitals closed down: http://allafrica.com/stories/201010070580.html

Hope springs eternal in the scientific world: ‘ perhaps there’ll be a new drug or we’ll rediscover an old one to combat this strain ‘

  In a March 2013 recent report from one top SA expert Prof Tommie Victor in Stellenbosch, (left and above) seventeen out of the 400 multiple-drug-resistant (MDR) patients in the Eastern Cape tested by epidemiologists researchers of Stellenbosch University were identified as having ‘Total” or “Hyper-resistance’ to all the antibiotic drugs currently available in the world to combat this air-borne bacterial infection.

TB can be transmitted through the air from person to person and so it is highly infectious when TB patients cough out bacteria-containing spray which is then inhaled by others in ‘closed spaces’. For this reason, TB has also plagued the Huddled Masses for many centuries. And, over the past twenty years it has also become clear to international TB researchers that every antibacterial drug now available in the world is becoming less and less effective to combat it.

But hope springs eternal in the scientific world. Prof Victor was quoted by SA journalist Wilma Stassen as saying: “the name ‘totally drug-resistant (TDR) is not appropriate. We think there may be a cure for TDR among some of the new drugs currently being developed, or old medication not in use anymore.

“We really are facing bacteria that have become increasingly resistant and there are now some bacteria that are hyper resistant, irrespective of the definition,’ said Victor, one of the co-authors of the study published in the Emerging Infectious Disease Journal in March 2013.

Tuberculosis bacteria are ancient bacteria with powerful adaptation abilities – and they are fighting back against modern antibiotics. Researchers conducting the Stellenbosch University study where the ‘Hyper-TB’ strain was identified, warn that there probably are other ‘undiscovered’ Hyper-TB patients floating around due to the high level of ‘migration’ in southern African countries — but that they haven’t been provided the government-infrastructure to locate them. They will try to do so next year.

So this brings us neatly back to Thabo Mbeki. Could South African taxpayers demand that Mbeki give back to those medical researchers the funds looted during his watch from the SA National Tuberculosis Association (SANTA) and also, to open up his Swiss bank accounts to help fund the reopening of all those by now very delapidated TB hospitals which used to do such a great job at keeping TB at bay inside the country?

other links:

Prof Thomas Victor et al: 109 research documents published:

http://www.ncbi.nlm.nih.gov/pubmed/?term=Victor%20TC[auth]

9 July 2001 Mbeki cabinet “reviews” funding for SA National TB Association (SANTA)

http://www.doh.gov.za/docs/pr/2001/pr0709.html

Three more TB hospitals closed down:

http://allafrica.com/stories/201010070580.html

Doctors call for Stringent Border Controls to Prevent Outbreaks of Infectious Diseases:

http://www.who.int/csr/don/2008_10_10/en/index.html

2006 report by Yale School of Medicine researcher Gerald Friesland noted that drug-resistant TB was spreading and ‘has become a major health problem in the southern African region’. “The increased incidence of MDR TB, XDR TB, and HIV infection places a tremendous burden on the region’s health care systems. An outbreak of XDR TB in Tugela Ferry, KwaZulu-Natal Province, South Africa, reported in 2006, raised great concern about transmission in health care, community, and household settings. Since 2006, cases of XDR TB have occurred in all provinces of South Africa and in all surrounding countries.The HIV epidemic in southern Africa has exacerbated the spread and virulence of drug-resistant TB. Knowledge of the true extent of the MDR/XDR TB epidemic is hampered by a lack of in-country laboratory capacity and the inadequacies of the existing health system infrastructure. Open book: http://www.nap.edu/openbook.php?record_id=12993&page=9

Switching patrolling SA borders from defence force to police: security problems outlined in Aug 2001 report:

http://dspace.cigilibrary.org/jspui/bitstream/123456789/31289/1/paper52.pdf?1

Mbeki, interviewed in 2000 on the subjects of HIV-AIDS and Tuberculosis:

TIME: You’ve been criticized for playing down the link between HIV and AIDS. Where do you now stand on this very controversial issue?
Mbeki: Clearly there is such a thing as acquired immune deficiency. The question you have to ask is what produces this deficiency. A whole variety of things can cause the immune system to collapse. Now it is perfectly possible that among those things is a particular virus. But the notion that immune deficiency is only acquired from a single virus cannot be sustained. Once you say immune deficiency is acquired from that virus your response will be antiviral drugs. But if you accept that there can be a variety of reasons, including poverty and the many diseases that afflict Africans, then you can have a more comprehensive treatment response.
TIME: Are you prepared to acknowledge that there is a link between HIV and AIDS?
Mbeki: No, I am saying that you cannot attribute immune deficiency solely and exclusively to a virus. There may very well be a virus. But TB, for example, destroys the immune system and at a certain point if you have TB you will test hiv positive because the immune system is fighting the TB which is destroying it. Then you will go further to say TB is an opportunistic disease of aids whereas in fact TB is the thing that destroyed the immune system in the first place. But if you come to the conclusion that the only thing that destroys immune systems is hiv then your only response is to give them antiretroviral drugs. There’s no point in attending to this TB business because that’s just an opportunistic disease. If the scientists … say this virus is part of the variety of things from which people acquire immune deficiency, I have no problem with that.

Read more: http://www.time.com/time/world/article/0,8599,2050899,00.html#ixzz2OSEgvsR3

Ancient Egyptians suffered from Tuberculosis:

http://mysteries24.com/n3-5189-Ancient_egyptians_suffered_from_Tuberculosis

South Africa’s KhoiSan came from Sahelian region of Africa:

 http://www.scienceinafrica.co.za/2002/august/khoi.htm

Archaeology of tubercle bacilli and tuberculosis: can be tracked back 2,5million years: mycobacteria adapted to humans in central Africa, then carried to India-Oceanian and Middle-East Countries:

Kekkaku. 2010 May;85(5):465-75.[Article in Japanese] Iwai K, Maeda S, Murase Y. Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose-shi, Tokyo 204-8533, Japan. Iwai@jata.or.jp – “Accumulated information obtained in the 10 years since the clarification of the whole genome arrangement of tubercle bacilli has enabled us to presume a long history of tubercle bacilli from its first appearance on earth to the present epidemics in the world. It is presumed that tubercle bacilli appeared around 35,000 years ago through horizontal transfer mutation from a kind of environmental mycobacteria that could be tracked back 2,500,000 years, and expanded thereafter by ‘bottleneck effects’. These mutated mycobacterial species adapted to humans, appearing in central Africa and then being carried to India-Oceanian and Middle East countries. The oldest human bone tuberculosis in a mummy of 9,000 years ago was found on the east coast of the Mediterranean Sea. Explosive transmission of tuberculosis was presumed to have progressed along with urbanized human life in the world-oldest Mesopotamian culture, followed by spreading to other areas, including East Asia, the Mediterranean region, Russia, and North Europe. The second epidemics, caused by a mutated Beijing family of the modern type, prevailed in central China and Southeast Asian countries, following the marked population growth in this area during the next 1,000 years. The majority of Beijing family strains isolated in Japan and Korea are, however, found to be of the ancient type, differing from the isolates from continental China, which are mainly of the modern type. The results of these studies may cast a new light on the understanding of tuberculosis epidemiology and also clinical medicine. PMID: 20560402 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/20560402

Tuberculosis existed in the ancient peoples of the New World long before the arrival of Columbus:

“To date, the earliest primary evidence of American tuberculosis has come from mummified remains from the first millennium C.E. recovered at the costal site of Caserones in the Atacama desert of northern Chile. In 1981, Allison et al. [7] reported finding acid-fast bacilli in cavitary pulmonary lesions in 2 mummies recovered from the site and in the healed ghon complex of a third. Numerous other archeological sites in the Americas have yielded evidence (primarily skeletal) of 1 or more additional pre-Columbian cases of tuberculosis, the heaviest concentrations of which exist in South America and in North America, north of Mexico. (figure 2) [3]   http://cid.oxfordjournals.org/content/41/4/515.full

TB and HIV response in South Africa:  The Lancet 2008

http://www.sciencedirect.com/science/article/pii/S0140673609609168

HIgh TB burden in South Africa: World Health Organisation 2011:

Government source:  http://www.doh.gov.za/docs/stats/2011/SouthAfricanTuberculosisProfile2011WHO.pdf