South Africa: SA's Plans to Reduce TB Infections On Track - Phaahla

Health Minister, Dr Joe Phaahla, believes that South Africa is on track to meet the World Health Organisation (WHO) target to reducing Tuberculosis (TB) cases by 50% by 2025 based on the latest statistics.

The Minister announced on Tuesday that the estimated TB incidence dropped from 644 000 to 304 000 between 2009 and 2021.

Through the implementation of the TB Recovery Plan, Phaahla said the country is starting to see improvements in TB testing, notification, and incidence.

The plan aimed at reverse the negative effects of the COVID-19 pandemic is a target-driven, evidence-based strategy to finding people with undiagnosed TB, strengthening linkage of people diagnosed with TB to treatment, care and prevention.

The Minister was speaking during the TB Indaba 2023 before the 11th South Africa Aids Conference in Durban.

According to the Minister, the country experienced some recovery in TB testing, with 1.9 million tests done in 2021 and 2.5 million in 2022.

"This gives us signs that indeed this recovery plan will take us back where we were before the pandemic."

Meanwhile, TB notification jumped from 187 735 in 2021 to 226 689 in 2022, exceeding the target of 215 900.

"These trends are consistent and robust and provide encouraging evidence that we are on track to meet global targets, because that is where we best compare ourselves with other countries in the world. We intend to move even faster and further to ensure that we fully recover losses suffered," he explained.

"Based on 2021 estimates, we are on track to meet the WHO target for reduction in TB incidence rate in 2025 of 50%, and we are likely to meet the 2030 SDG [Sustainable Development Goals] target of 80% reduction in TB incidence rate."

The government, according to the Phaahla, is recommitted to continue to accelerate the decline of TB incidence.

COVID-19

South Africa is on the three global lists of high-burden countries for TB, HIV-associated TB, and drug resistant TB.

The WHO estimates that over 110 000 people with TB in South Africa lost their lives between 2020 and 2021.

Since 2010, over one million citizens are estimated to have succumbed to TB, which is preventable and curable.

The Minister said the COVID-19 pandemic and associated lockdowns severely affected TB services throughout the country.

Between 2019 and 2020, the number of TB tests provided in South Africa decreased by 23% and case notifications decreased by 25%.

"There has been some recovery since 2022, but it is estimated that the pandemic has reversed 12 years of global progress against TB."

The Minister reminded delegates that the pandemic affected everyone including families, communities, economies, the country, and the world.

"Over the past three and a half years, we have endured the most important public health crisis of our lifetimes."

By the end of 2022, 104 000 citizens had died due to COVID-19 or almost triple the number if the South African Medical Research Council (SAMRC) surveillance of excess deaths are taken into account.

Interventions

Phaahla said some new interventions and developments to end TB include the expanded screening activities with TB Health Check, as well as the use of digital chest x-ray for TB screening.

For the people with undiagnosed TB, government plans to screen one million people, 60% of People Living with HIV/AIDS (PLHIV) tested and notification of 215 900 patients through annual TB tests.

Government will also introduce TB results notification system to patients via SMS to improve linkage to treatment.

The state also plans to introduce more patient-friendly treatment regimens, four-month paediatric drug-susceptible TB and six-month drug-resistant TB regime, to improve retention in care.

"A TB vaccine is advancing to a phase III trial in South Africa, with promising results."

Phaahla said about 60% of TB patients are people living with HIV, which provides an opportunity for better patient's outcomes.

"We will work toward a system that provides better care, through shorter regimens and tailored support in facilities and communities. We will work toward a system that values prevention as much as treatment and supports both the users and the providers of the health services."

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