Tuberculosis continues to plague South Africa: A call to action for young people

Despite being completely preventable and curable, tuberculosis (TB) stands as South Africa's most significant public health challenge, claiming approximately 56 000 lives each year. This grim statistic includes 25 000 individuals who were HIV-negative and 31 000 who were living with HIV, as reported by the World Health Organisation (WHO).

With an alarming incidence rate of 427 cases per 100 000 people in 2023, health authorities reveal that more than 270 000 new infections occur annually, disproportionately affecting children and young adults.

“Tuberculosis is an airborne disease that often remains unnoticed until it's too late,” says Dr. Kgomotso Thipe, Gauteng Provincial Medical Manager for AIDS Healthcare Foundation (AHF) South Africa.

“It spreads in closed spaces when someone with active TB coughs or sneezes, leaving many unsuspecting people vulnerable.” The Department of Health has initiated an ambitious END TB CAMPAIGN, aiming to significantly decrease TB incidence and mortality in the nation by 2035, by testing five million people in the 2025/26 period.

Understanding tuberculosis

TB is a serious lung infection caused by bacteria. It spreads through the air, and many carriers may be unaware of their infection for weeks or even months. Symptoms often manifest as a persistent cough, fatigue, night sweats, or unintended weight loss.

Particularly concerning is the emergence of drug-resistant tuberculosis (DR-TB), which occurs when the TB bacteria no longer respond to standard treatment - a situation exacerbated by improper medication adherence, leading to a tougher, more expensive treatment journey.

Societal perceptions can significantly hinder progress in combating TB. Misunderstandings persist, with some communities erroneously attributing the disease to “witchcraft” or “bad luck”.

“We must address stigma and promote the understanding that TB is a treatable medical condition,” Dr Thipe urges. “Fear and misunderstanding shouldn’t prevent individuals from seeking diagnosis and treatment.”

The growing danger

The danger of TB lies not only in its insidious nature but also in its quick transmission in closed, crowded environments, such as mines and high-density living areas. Additionally, numerous biosocial factors contribute to the crisis, particularly the intertwining relationship between TB and HIV. Approximately 54% of TB patients are also HIV-positive, underscoring the necessity of integrated testing and treatment strategies.

“We've always recommended concurrent screening for HIV and TB,” states Dr Thipe.

A multifaceted approach to solutions

As TB continues to be erroneously viewed solely as a disease of poverty, stigma remains a formidable barrier to early diagnosis and effective treatment. “People are still scared to talk about TB, but it is not a death sentence,” asserts Dr Thipe.

“We need to break the stigma. Without open conversations, we risk losing lives.”

Despite free TB services in South Africa, the financial burden on patients remains huge, with costs for transport and the necessity for nutrition posing significant hurdles to accessing care.

Yet hope persists. The Department of Health's TB Recovery Plan, set for April 2025 to March 2026, includes pivotal strategies such as:

• The rollout of a six-month BPAL-L regimen for DR-TB, benefiting over 7 400 patients since its initiation in September 2023
• The introduction of a shortened four-month TB regimen for children in 2024
• The implementation of short-course preventive treatments (3HP and 3RH) projected to significantly reduce new infections.

The government is committed to restoring TB services disrupted by the COVID-19 pandemic. With nearly 3 million TB tests conducted in the previous year, efforts continue to bolster case detection through the comprehensive National TB Recovery Plan.

“We need young people to take charge and participate in community awareness initiatives,” Dr. Thipe emphasises.

AHF South Africa's response

In alignment with the Department of Health’s objectives, AHF South Africa is ramping up its advocacy efforts across the country, focusing on reducing stigma and accessing barriers. The organisation collaborates with local health departments to offer support addressing essential social determinants, such as poverty and food insecurity, that hinder individuals from obtaining the care they need.

“We are committed to supporting individuals facing real struggles,” shares Dr Thipe.

“TB care must encompass more than just medical support; it requires holistic approaches, including nutritional assistance and mental health resources.”

Your role in the fight against TB

Individuals are urged to take an active role in combatting TB:

• Get tested if you have a cough persistent for 24 hours.Complete your treatment if prescribed TB medication.
• Encourage open dialogue about TB within your communities.
• Don’t hesitate - early action can save lives.

“Yes, we can end TB. But only if we treat it with the urgency it demands,” concludes Dr Thipe.