Tuberculosis explosion in South Africa blamed on weak public health system
http://www.guardian.co.uk/global-development/2012/sep/10/tuberculosis-south-africa-weak-public-health
A tuberculosis patient takes a dose of pills at a clinic in Alexandra township, north of Johannesburg. Photograph: Stephane De Sakutin/AFP/Getty Images
Weaknesses in South Africa's public health system have been cited as being among the reasons tuberculosis has increased four-fold in the past 15 years. Addressing the country's failure to control and cure TB, Veloshnee Govender of the University of Cape Town's health economics unit told a major conference on poverty alleviation that there has been a 400% increase in TB incidence.
In line with recommendations by the World Health Organisation (WHO), treatment of TB follows the DOTS (directly observed treatment short course) protocol, which requires that TB patients take medication daily in front of a health worker who administers and "observes" that this is done correctly.
Treatment of TB usually requires a daily dose of drugs for six months, but in more severe cases it may require a longer period. Given the long distances some patients have to travel to get to clinics, or the inconvenience of fitting in daily visits, many patients do not take their medication as diligently as they should.
However, the WHO protocol also states that the "whole purpose of treatment observation would be defeated, were it to limit access to care, turn patients away from treatment or add to their hardships".