Drug-proof TB dilemma

The government has no policy to detain patients infected with extreme drug-resistant tuberculosis (XDR-TB), said acting Health Minister Jeff Radebe, pictured.

The government has no policy to detain patients infected with extreme drug-resistant tuberculosis (XDR-TB), said acting Health Minister Jeff Radebe, pictured.

The Health Department had sought advice from legal experts and the Medical Research Council in this regard, he said yesterday in a written reply to a parliamentary question.

This had highlighted that detaining patients infected with XDR-TB would violate several human rights.

But, Radebe said, XDR-TB was a public health issue, and it was his department's responsibility to "uphold the constitutional rights of the people of South Africa to an environment that is not harmful to their health or well-being".

There was an "ethical and legal obligation to ensure that communities are protected from acquiring the infection and suffering the consequences".

Radebe said the approach was to isolate patients with infectious XDR-TB until they were no longer infectious, and the discharge them.

"This is done after education and counselling of the patient and the immediate family about the disease and the treatment with written consent, which makes it a voluntary process.

"It is only with patients who refuse voluntary hospitalisation where legal recourse is sought to enforce it."

That did not guarantee the patients would take their medication.

Authorities could not enforce treatment considering the toxicity of the drugs and uncertainty around treatment success, as it would violate the individual's rights to freedom, security and bodily integrity.

"The dilemma lies with patients who have failed treatment and remain infectious, as there are no third-line drugs.

"These patients would have to be hospitalised indefinitely or until they die," he said.

A policy on isolation that would take all these medico-legal issues into consideration was being developed. - Sapa

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