Reach the 3 Million - Find, Treat, Cure TB

1   The World Health Organisation's Global TB Report in 2013 stated that three million people with tuberculosis (TB) are missed every year by health systems. The theme of the World TB Day on 24 March this year, "Reach the 3 million - Find, Treat, Cure TB", highlights the importance of effective case detection and diagnosis to reduce the number of undiagnosed and untreated TB patients worldwide. On this day, the Ministry of Health (MOH) joins the global community in supporting the call to find, treat and cure TB so as to reach the goal of a world with zero TB deaths, stigma and infections.

Further subsidies for TB management

2   To successfully control TB in the community, it is important to ensure that all patients with TB are diagnosed early and undergo treatment until cured, so as to prevent further transmission. As TB treatment typically lasts 6 months, the out-of-pocket medical expenses can become a barrier to some patients.

3   Currently, TB patients who are placed under Directly Observed Therapy (DOT) under the National TB Programme already have their medications fully subsidized by MOH. With effect from 1 April 2014, Singapore citizens and permanent residents who are receiving outpatient TB treatment at the Specialist Outpatient Clinic 'K' in Tan Tock Seng Hospital will pay a flat rate of $10 and $15 per consultation visit respectively. The flat fee covers consultation, basic investigation and laboratory tests associated with outpatient management of TB. The out-of pocket cost to patients is thus substantially reduced over the entire outpatient treatment regimen. 

Greater community effort needed to reduce TB

4   TB is curable and the spread of TB is preventable. While national control measures are in place to reduce the risk of ongoing transmission, each of us play an important role in keeping our community safe and free of TB. Individuals who display TB symptoms should seek medical attention early to ensure prompt diagnosis. TB patients should adhere to the full treatment to avoid development of drug resistance. As part of social responsibility, proper cough etiquette (e.g. coughing into tissue) should be observed to prevent transmission.

5   The National TB Control Programme (through the TB Contact Clinic) undertakes contact screening for infectious TB cases in homes, schools and workplaces. The aim of contact screening is to detect persons who may have latent TB infection (LTBI) or active TB disease. Prompt detection of contacts with active TB disease ensures that those who are unwell can be referred to medical care as soon as possible. Persons with LTBI are physically well and not infectious. They are able to continue with their daily routine and go to work or school. However, about 10% of persons with LTBI may develop symptoms of active TB disease over their lifetime. Preventive treatment can therefore reduce the likelihood of progression to active TB disease. While contact screening is usually voluntary, we advise persons who have been contacted by the TB Contact Clinic to undergo screening so as to be informed of their LTBI status and to be offered counseling and preventive treatment if necessary.

6   As TB treatment takes six to nine months to complete, strong support from family members, friends and the community is essential to encourage patients to finish their treatment regimen. Employers should be supportive of TB treatment for their workers, by granting them the flexibility to go to polyclinics for DOT when necessary. Generally, a TB patient becomes non-infectious after just two weeks of treatment, this period being covered by medical leave. There is thus no increased risk of infection in the workplace when the TB patient returns to work. Treatment compliance and completion will benefit the patient, his family, his workplace and the community.

7   The Health Promotion Board (HPB) continues to actively engage the community and workplaces to promote an understanding of how to prevent infectious diseases, including TB. As part of its outreach efforts to schools, the HPB has forged partnerships with the Singapore National Employers' Federation and the Tsao Foundation to extend public TB education to the general population as well as targeted groups who are at risk. In addition, public education efforts focusing on older adults will emphasise early detection of TB through recognition of symptoms, and the treatability of the disease. As of December 2013, these talks have reached more than 2500 people.

8   With everyone playing their part, we can reduce the community transmission of TB in Singapore. More information on TB is available at MOH’s website or HPB website.

 
MINISTRY OF HEALTH

24 MARCH 2014

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See ANNEX - Update on the Tuberculosis Situation in Singapore