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8 Convergence of Science and Policy to Create a Blueprint for Action
8 Convergence of Science and Policy to Create a Blueprint for Action
Pages 81-88
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From page 81... ...
; Janet Tobias, Ikana Media; and Martie van der Walt, then raised additional issues and responded to questions from workshop participants. This chapter synthesizes the points made, as well as a number of individual suggestions for actions to address urgent needs related to drug-resistant TB, in the areas of epidemiology, infection control, diagnostics, treatment, pediatric TB, research needs, and the need for partnerships.
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From page 82... ...
In addition, the creation of a culture of safety through infection control policies could provide greatly increased protection for patients and health care workers. Abdool Karim stated that infection control should be a part of every TB intervention and needs to begin when a patient is identified, diagnosed, and hospitalized.
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From page 83... ...
Parsons suggested that a process for making interim diagnoses while awaiting the results of more detailed yet time-consuming diagnostics is needed to identify potential TB cases and the strains involved so health care workers can assist with managing patients in the community. TREATMENT Although the cure rate of MDR TB in South Africa and surrounding countries remains uncertain, drug-resistant TB clearly is not being managed well enough, suggested Ndjeka.
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From page 84... ...
Health care workers will also need training in the diagnosis and treatment of coinfection with HIV, according to van der Walt. Parsons remarked that funding of $13−$15 million was recently received to increase bed capacity in South Africa.
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From page 85... ...
Van der Walt noted that new policies could raise human rights concerns and foster public panic; nevertheless, the extent of the problem needs to be communicated, and policy makers will need assistance with the ethical issues associated with untreatable cases.
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From page 86... ...
Indeed, it does not comply with the guidelines of the country's own Department of Health. Monitoring and evaluation are not being performed efficiently, the time required for injectable drug treatments contributes to defaulting, and patients and communities need more information about MDR TB.
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From page 87... ...
• What proportion of cases can be attributed to health care facilities, transmission in the community, or evolution of the organism? • How can preventive, diagnostic, and therapeutic operations in health care facilities, including infection control, be changed and improved?
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From page 88... ...
Bond noted that ASSAf is in an excellent position to continue to convene groups to address the issues surrounding MDR and XDR TB and to solicit the input of a broad array of groups that include patients; health care workers; public health officials; policy makers; the academic community; and groups from the sectors of industry, government, academia, and advocacy.
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