April 2, 2014
Speech by the Executive Deputy Mayor, Alderman Ian
Neilson
At the opening of the 16th International Conference on
Infectious Diseases
President of the International Society for Infectious Diseases,
Dr Keith Klugman
President of the Federation of Infectious Diseases Societies of
Southern Africa, Dr Marc Mendelson
Minister Alan Winde
Delegates
Good evening.
It is my great honour to welcome you to the 16th International
Congress on Infectious Diseases and thank you for bringing
your congress to Cape Town.
We are so pleased to have such a geographically diverse group
of attendees and we hope that you manage to take some time
out from what I’m sure will be a very full schedule to enjoy the
many delights our City has to offer.
The importance of engagements like this should not be
underestimated.
In order to be truly effective, platforms for sharing knowledge
are critical.
Conferences such as this one allow leaders in their respective
fields to exchange ideas, discuss research and developments
and allow a range of stakeholders to participate in a
collaborative manner.
2
The relatively recent ease with which many of us can travel to
all parts of the world in short spaces of time has meant that
infectious disease breakouts can no longer be easily contained
and as such is no longer the concern of just specific areas.
Rather it is everyone’s problem. Infectious diseases remain a
major cause of suffering and death in developing countries, and
an ever-present threat to richer countries.
And so we must all work together to overcome the challenges
we face – to mobilise, to ensure political will and to find the
resources necessary to develop ways to address the outbreaks
of infectious diseases.
For true success, multiple partners and sectors must
collaborate and co-ordinate their work. If each of us
consistently puts in the necessary efforts, we know, as we have
seen before, that thousands, even millions, of lives can be
saved.
For our part, the City of Cape Town, a city of 3.8 million
people, does as much as we can within our resources to ensure
that the City is prepared, alert, vigilant with regards to early
identification, and has a well-coordinated and rapid response to
prevent, mitigate and control communicable disease outbreaks
and epidemics.
The City has 100 health facilities spread across the city where
the Extended Programme of Immunization is managed. The
City receives all notifications, does the case investigation,
contact tracing, prophylaxis where needed and submits
outcome reports to the Provincial and National Centres for
Disease Control.
Children are immunized against nine different diseases
including polio, measles, hepatitis B and rotavirus.
A variable number of doses are administered at various ages.
In 2012, Cape Town achieved immunization coverage of 91%.
3
The City has a well-functioning routine surveillance system that
receives, collates, and submits reports of notifiable conditions
and outbreaks with details of cases, deaths and contacts for
monitoring and evaluation purposes, including trends over
time.
We also have a 24-hour helpline available to our residents to
receive and pass-on to relevant officials, reports of
communicable diseases and suspected outbreaks for action.
The City, amongst other initiatives, does HIV testing, condom
distribution, ARV enrolments, TB caseloads and STI treatment
at clinics.
We have made significant strides in combatting TB. Reported
figures of TB incidence have decreased from 877/100 000 of
the population in 2009 to 663/100 000 in 2013.
A new Xpert TB test has been introduced incrementally into the
National Health Laboratory Service since 2011 and roll-out in
Cape Town was completed in 2013. This has contributed to
significantly reducing the time between screening and the
commencement of treatment to three days.
Currently, 83% of all patients who have started TB treatment
at the City of Cape Town’s facilities have successfully
completed their treatment and have been cured.
Community care workers have been employed to visit and
provide support to our patients in their own homes and ensure
that they are sticking to their regimen.
Whilst there is much still to be done, there have been many
positive strides including the fact that 98% of TB patients were
offered and accepted an HIV test. Some 44% of all TB patients
are co-infected and 81% of all HIV positive TB patients are on
antiretroviral treatment.
4
In 2013, 1 128 drug resistant TB patients started treatment –
122 of them with Extreme Drug Resistant TB. The time
between diagnosis and treatment for MDR TB patients has
reduced from on average 36 days in 2010 to 11 days in 2013.
Decreasing time to treatment should contribute to decreased
transmission in our communities.
As part of the City’s World Design Capital projects, AntiRetroviral Clubs are becoming increasingly popular. This
innovative idea is aimed at reducing the time patients spend
waiting for ARV medication, eases the pressure on congested
facilities, and enables staff to focus on sick patients.
Stable patients are divided into groups of 30 or less and, at an
appointed time, they go straight to a club room with their card.
There they are weighed and have a symptom check. In less
than an hour they leave the clinic with their pre-packed
medication.
The club enables patients to socialise and gives them the
opportunity to have group discussions about HIV-related
issues.
There are over 900 ARV clubs at more than 40 treatment
facilities which cater for over 20 000 patients in Cape Town.
Another project that the City has started is male specific clinics.
These clinics offer a male-friendly environment in which
patients can access primary health care, receive education on
safe sex, obtain STI diagnosis and treatment, and receive HIV
testing and counselling. Referral services for ARV initiation and
for medical male circumcision are also available.
5
Since the establishment of male clinics in 2007, numerous
successes have been reported. These include the 12 000 HIV
tests that have been administered at the two male clinics in
Khayelitsha and the more than 50% reduction in sexually
transmitted infections in the area.
In 2012, nearly 600 000 people were tested for HIV in the
Cape Metro. More than 24 000 people were enrolled on
antiretroviral drugs and nearly 100 000 were on ARVs in care
at predominantly primary health-care facilities by year end.
The transmission rate of HIV to babies born to HIV positive
mothers was below 2%.
More than 76 million male and 1,6 million female condoms
were distributed.
We know that when we have buy in from our residents, and
our Provincial and National partners and various stakeholders
(including each of you) we will be able to make even more
progress possible.
This City administration will continue to work with its
communities to meet the challenges that come with infectious
diseases.
Again, welcome to all you of and I wish you well with your
engagements.
Thank you very much