Monday 10 September 2012

TUBERCULOSIS: World Bank President Jim Kim blogs on TB, mining and Africa


On 7 September, World Bank President Jim Kim posted a blog on his recent mission to South Africa: ‘A Great Day in South Africa for a Development Junkie’. In the blog he reflects on his meeting with President Zuma and his ministers and describes the importance of deeper Bank engagement in Africa, including on tuberculosis (TB

The Stop TB Partnership welcomes Dr. Kim’s proposal for a World Bank leadership role on the issue of TB in the mining sector and is in full support of efforts to find a regional solution to this issue. Three members of the Stop TB Partnership Coordinating Board have served as champions on TB and mining and spearheaded the drive that led to signing of the Declaration on TB in the Mining Sector by heads of state of the Southern African Development Community on 18 August. They are: Dr Aaron Motsoaledi, Minister of Health of South Africa; Dr Mphu Ramatlapeng, Vice-Chair of the Global Fund Board and former Minister of Health of Lesotho; and Mr Benedict Xaba, Minister of Health of Swaziland.

PRETORIA, South Africa - I have to admit it. I’m a bit of a development junkie. For most of my adult life, I’ve been reading thick tomes describing the success or failure of projects. I talk to friends over dinner about development theory. And I can’t stop thinking about what I believe is the biggest development question of all: How do we most effectively deliver on our promises to the poor?
So you can imagine how excited I was to have a day full of meetings with South Africa’s foremost experts on development: the country's ministers of finance, economic development, health, basic education, water and environmental affairs, and rural development and land reform - and then with President Jacob Zuma.

I chose to travel to South Africa as part of my first overseas trip as president of the World Bank Group because of the country’s great importance to the region, continent, and the world. It is the economic engine of Africa, and its story of reconciliation after apartheid is one of the historic achievements of our time.

DEEPENING OUR RELATIONSHIP WITH SOUTH AFRICA

I came to learn about what its leaders see as successes in development that can be used in other countries as well as to hear about its most stubborn challenges. In the end, I wanted to explore how the World Bank could deepen its partnership with the country.

So after several hours of detailed discussions - we covered issues including job creation, climate change, school dropouts, and putting women at the center of economic development - we emerged to hold a news conference across the street from the Union Building, the seat of government.

To my left was Pravin Gordhan, South Africa’s minister of finance since 2009 and one of the leaders of the underground anti-apartheid movement. In several hours of meetings with Minister Gordhan, I found that we share a deep impatience to find solutions to tough development issues and at the press conference, he confirmed that we share a common ancestry - we are both activists.

To my right was Makhtar Diop, the Bank’s eloquent and effective vice president of the Africa region, who had led our efforts in Brazil and Kenya and had been finance minister in his native Senegal.

A SPECIAL MOMENT

My visit to South Africa was a special visit for several reasons - the extraordinary intelligence and commitment of the officials, the commitment to a much deeper collaboration between the Bank and the South African government (Minister Gordhan would say in the press conference that relations with the Bank were about to enter a “new era”), and the fact that one of the areas of possible collaboration with the government was on an issue dear to my heart: fighting the spread of tuberculosis (TB), especially drug-resistant TB.
For two decades, first at Partners in Health and later as the head of HIV/AIDS programs at the World Health Organization, I was involved in developing policies and programs that secured treatment for people who had contracted the difficult-to-treat multiple drug-resistant TB. I felt that South Africa, with its expertise in treating both HIV/AIDS and TB, could help lead an effort to contain the spread of TB in the region.

Tuberculosis is a major problem in the region and among the highest burden countries in the world, five are in Southern Africa. Here, controlling TB is made much more difficult because of the mobility of workers, especially miners. Miners are seven times more likely to contract TB than the general population and when they travel home on holidays from South Africa to Lesotho or Swaziland, they will often stop taking their medication and in the process, their strains can develop drug resistance and be passed to family members.
What we can do

The Bank is in a great position to make a difference in tackling TB in the region. We have the world’s deepest bench of development experts and much of the problem is related to systems, not necessarily medical care. To effectively follow people with TB throughout the region, we will need to improve communications, laboratories, and other elements of infrastructure, an area where we have lots of expertise. We can convene all the relevant partners and help to build a truly regional response to an epidemic that does not respect borders.

I spoke a bit about TB and miners at the press conference and I left South Africa with great optimism that, in collaboration with global partners and health experts in South Africa, Lesotho, Swaziland, and other southern African countries, we could push forward a regional effort to stop the spread of TB and save many lives.

What a great trip for a development junkie! How privileged we all are at the World Bank to work every day to boost prosperity and end poverty.
One other important thought: I also visited the Mailtronic Direct Marketing factory, a family-owned direct mail business. The Moodley family started out with six employees in 1991 in its garage. Since 2009, the Bank’s International Finance Corporation (IFC), our private sector investment arm, has invested $40 million to Sasfin Bank, which in turn provided a $1.5 million loan to Mailtronic. That allowed the company to purchase high-tech printing presses and software, growing the business to $8.5 million in revenue annually and employing 80 people.

This is a great story, and this is something we need to do more of around the world. The key to our mission of ending poverty and building prosperity is to help hard working entrepreneurs create jobs. The IFC has been that spark plug in South Africa.

Republished courtesy of the World Bank

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