TB infections down but concern remains over death rate

While the tuberculosis infections in the country are dropping government is concerned about the death rate among patients.

This was highlighted by Deputy Health Minister, Dr Sibongiseni Dhlomo, during his keynote address delivered on the opening day of the BRICS Tuberculosis (TB) Research Network Innovation Summit in Durban, on Monday.

“TB remains a pressing concern for South Africa, as it does for all BRICS countries and many nations,” Dr Dhlomo said.

“About 300 000 people are estimated to get TB every year in South Africa. Last year alone, we managed to notify and put 224 000 people on a TB treatment regimen. Although our infection incidence is declining, we are concerned about the unacceptable death rate among our TB patients.”

According to Dr Dhlomo, a major driver of TB infection is HIV – with 48% of TB patients living with HIV in 2022. The good news, he said, was that the country’s antiretroviral programme had led to a decrease in TB incidence.

The BRICS nations (Brazil, Russia, India, China and South Africa) carry a disproportionate burden of drug-susceptible and drug-resistant TB infection and neglected diseases of the South, the Dr Dhlomo added.

To address this public health threat, the BRICS TB Research Network was established in 2017 to bring together programme managers and scientists to exchange information and formulate redress strategies and solutions.

“The ultimate goal of this endeavour was to establish collaborative research programmes aimed at developing new diagnostics, drugs, and vaccines for TB. The TB control programmes from the various representative countries also undertook to learn from each other on key aspects of financing and strengthening the health systems in their respective nations,” said Dr Dhlomo.

He added that following the devastating impact of Covid-19 on public health programmes, South Africa developed a TB Recovery Plan to trace missing TB patients, linking them to care and creating a demand for testing. TB prevention and improvement of data systems are also prioritised.

Dr Dhlomo cited the sixth report on South African National HIV Prevalence, Incidence, and Behaviour among people aged 15 years and older living with HIV in South Africa in 2022. According to the data, 90% were aware of their status, 91% of those aware of their status were on antiretroviral treatment, and 94% of those on antiretroviral treatment were virally suppressed, he said.

“South Africa has made significant progress toward the UNAIDS 95-95-95 targets that by 2025, 95% of all people living with HIV to be aware of their HIV status, 95% of those aware of their status to be on antiretroviral treatment, and 95% of those on antiretroviral treatment who also know they are living with HIV to achieve viral load suppression,” said Dr Dhlomo.

He added that the country has been at the forefront of introducing and scaling up new tools for diagnosis and shorter treatment regimens for drug-resistant TB. However, he said, there is a need to do more to improve linkage to care and retention in care. He also believes that BRICS countries have made significant strides since the establishment of this network, with progress and some challenges.

Dr Dhlomo touched on the United Nations General Assembly High-Level Meeting on TB, in New York, in September this year.

“We should work very hard to ensure that we meet the targets we have set ourselves for this summit,” he said.

“The targets include the creation of innovations in therapeutics, diagnostics, and vaccines that the network can prioritise for collaboration, investment and development.

“A world without TB is not just an aspiration but an attainable reality, and we should stand ready to play our part in making that vision a shared triumph. I believe this network can make a significant contribution to this end. The goal to end TB is within our grasp. Our collective efforts must transcend borders, ideologies, and individual interests.”