Common use of Tuberculosis Clause in Contracts

Tuberculosis. The World Health Organisation (WHO) estimates that about 1% of South Africans (roughly 490,000) contracted Tuberculosis (TB) in 2008, giving an incidence rate of 949 TB cases per 100,000 population. The incidence is much higher in high risk concentrate settings such as the mines and prisons, with the former estimated at between 3,000 and 7,000 cases per 100,000 per population. Tuberculosis is both a medical condition and a social problem and is linked to poverty related conditions. Problems of overcrowding and poor social conditions as well as environmental factors are contributory factors to its increased burden. It is important that the Human Settlement and Environmental Affairs Departments join forces with health to address the social determinants of health. The current HIV/TB co-infection rate exceed 70%. Due to late detection, poor treatment, management and failure to retain TB patients on treatment, drug-resistant forms of TB (DR-TB) have increased significantly, with about 5,000 and 500 diagnosed respectively in 2009. Although the current policy by the Department of Health is that all DR-TB patients should be hospitalised until they are cured, there are about 2,000 beds available for DR-TB treatment and management. The combination of TB, HIV and DR-TB has led to a situation where TB is the number one common disease among diseased South Africans (13 out of every 100 deaths). Although resources have been made available for TB control and management, the bulk of these are routed, as earmarked funds, through different programmes, particularly, districts systems development, drug supply and hospital management. As a result, a significant amount of the resources end up being utilised for other purposes than TB. It has also proven difficult to keep track of the allocations and expenditure of these funds.