TB Indaba 2023: SA aims for ambitious 85% success rate in TB treatment programme

The Covid-19 pandemic and subsequent lockdowns have dealt a severe blow to TB services across South Africa.

Dr Joe Phaahla, South Africa’s minister of health, spoke at the TB Indaba held at Southern Sun-Elangeni, Durban, highlighting its significance as part of a wider advocacy and social mobilisation strategy devoted to emphasising communication and partnership to prioritise TB on the agenda.

The event served as a pre-meeting for the 11th SA AIDS Conference.

Dr Phahla also reflected on the deleterious impact of Covid-19 on society, stating that the world has suffered the biggest public health crisis in the last three and a half years, affecting everyone from individuals, families, communities, and nations to economies.

The pandemic has had a profound impact on humanity, prompting the need for action to address this issue effectively, including the need to prioritise TB on the broader agenda.

The Covid-19 pandemic and subsequent lockdowns have dealt a severe blow to TB services across South Africa.

He stated that between 2019 and 2020, the number of TB tests administered fell by 23%, and case notifications dipped by 25%.

While there has been a slight uptick since 2022, it is believed that the pandemic has undermined 12 years of global progress in tackling TB.

Already, South Africa is presently among the three nations in the world with the highest incidence of TB, drug-resistant TB, and HIV-associated TB.

The World Health Organization (WHO) has estimated that more than 110 000 patients with TB died in South Africa between 2020 and 2021.

Since 2010, over one million individuals in South Africa have succumbed to TB, despite the disease being preventable and treatable.

Approximately 60% of South African TB patients are people living with HIV.

Immediate response: TB Recovery Plan

“South Africa is at the forefront of TB research and development. There are some new interventions and exciting developments. e.g., Expanded screening activities with TB Health Check, as well as the use of digital chest X-ray for TB screening, ” said Phaahla.

He added, “For the people with undiagnosed TB, we plan to screen 1 million people, 60% PLHIV tested and notification of 215 900 patients through annual TB tests.

“This will be augmented by 300 000 chest x-rays screening. We will also introduce a TB results notification system to patients via SMS to improve linkage to treatment. We will soon be using new molecular diagnostic tests for TB.”

According to Phaahla, the South African government has set an ambitious target for treating tuberculosis patients.

The plan is to ensure that 85% of patients diagnosed through lab tests receive proper treatment, while 86% of drug-susceptible TB cases are retained under a strict and comprehensive treatment programme.

To improve retention in care for TB patients, the ministry is working on introducing more patient-friendly treatment regimens.

Such regimens would include a four-month paediatric drug-susceptible TB regimen and a six-month drug-resistant TB regimen.

In a significant development, a TB vaccine is advancing to phase III trials in South Africa, with highly promising results.

The vaccine’s effectiveness would be a game-changer for TB treatment, with South Africa facing some of the highest rates of TB infection in the world.

Should the TB vaccine prove effective in phase III trials, it could have a significant impact on eradicating the disease in the country, making an incredible contribution to the South Africa National Strategic Plan for TB.

“For us, the adage of prevention is better than cure is as relevant today, as it was when it was first said. The mainstay of us ensuring that we end TB is to invest in the prevention of services to reverse the trends,” concluded Phaahla.

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