REACH THE 3 MILLION - REACH, TREAT, CURE EVERYONE

1          According to the World Health Organization (WHO), three million people with tuberculosis (TB) are missed every year by health systems. The theme of WHO’s World TB Day on 24 March this year, "Reach the 3 million - Reach, Treat, Cure Everyone", therefore reiterates the importance of effective case detection and diagnosis to reduce the number of undiagnosed and untreated TB patients worldwide.

2          On this day, the Ministry of Health (MOH) stands in solidarity with the global community in supporting the call to find, treat and cure people with TB so as to reach the goal of a world with zero TB deaths, stigma and infections. In Singapore, there were 1,454 new cases of TB among Singapore residents in 2014 [see “Annex” for more details]. TB is curable and the spread of TB is preventable. While national control measures are in place to reduce the risk of ongoing transmission in Singapore, each of us plays an important role in keeping our community safe and free of TB.

3          Individuals who display TB symptoms (e.g. unexplained cough of 3 weeks or more) should seek medical attention early to ensure prompt diagnosis and treatment. As part of social responsibility, proper cough etiquette (e.g. coughing into tissue) should also be observed to prevent transmission. Generally, a TB patient becomes non-infectious after two weeks of appropriate treatment, a period covered by medical leave. There is thus no increased risk of infection in the workplace when a TB patient returns to work. 

4          The full course of TB treatment takes six to nine months. If patients do not adhere to their medications, there is a higher chance of developing drug resistance, treatment failure, and future disease relapse. Directly Observed Therapy (DOT) therefore remains a pillar of the Singapore TB Elimination Programme (STEP) as it is the best way of assuring patients’ adherence for the sake of their health and others’ around them. Patients’ family members, friends and the community should provide support and encouragement to ensure that TB patients successfully complete their treatment. Employers should also be supportive of TB treatment for their workers, by granting them the flexibility to go to polyclinics for DOT. Treatment adherence and completion will benefit not only the patient, but also his family, his workplace and the community.

5          STEP was revitalized in 2013 with various initiatives to remove barriers to TB detection and treatment. These include the progressive extension of contact tracing for TB to all work places to enhance detection. Since 1 April 2014, we have also increased subsidies for outpatient TB treatment at the TB Control Unit (TBCU) at Tan Tock Seng Hospital for patients who are Singapore citizens or permanent residents to reduce their financial burden. To cope with an expected increase in the number of elderly patients treated by TBCU, plans are underway to expand the outreach of the DOT programme to bring TB treatment to the homes of those elderly or non-ambulant.

6          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, HPB collaborates with partners, such as the Singapore National Employers Federation, to reach out to workplaces through the Workplace Infectious Diseases Education (WIDE) programme. Educational materials on TB are also disseminated to companies through human resource (HR) personnel.  From March 2013 to December 2014, these outreach efforts have reached more than 50,000 employees.

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

MINISTRY OF HEALTH

24 MARCH 2015

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SEE ANNEX