In the media

Harnessing hope: A call to tangible action on World TB Day

24 March 2024

Dr Nkateko Msimeki, General Manager Health Policy and Medical Advisory from AfroCentric writes about the state of TB in South Africa and what we need to do to bring an end to this age-old disease

As we all mark World TB Day, it's not only a time for reflection but also a moment to galvanise action against one of humanity's oldest and deadliest foes: tuberculosis (TB). This year's theme, "Yes! We can end TB!", should resonate deeply as a beacon of hope for us all because this fight is a critical one in South Africa and has been for a long time. Despite significant strides made over the last few decades, TB continues to exert a heavy toll on our society.

World TB Day marks the historic occasion in 1882 when Dr Robert Koch stunned the scientific world by revealing his discovery of the cause of tuberculosis: the TB bacillus. In an era when TB ravaged Europe and the Americas, claiming the lives of one in seven individuals, Koch's breakthrough heralded a new era in the fight against the disease. His revelation paved the way for improved methods of diagnosis and treatment, offering hope to millions affected by tuberculosis. While the likes of Europe and North America have made great strides, TB remains a critical challenge in South Africa.

According to the latest data from the World Health Organisation (WHO), an estimated 54,200 people in South Africa succumbed to TB in 2022, while approximately 280,000 fell ill with the disease. These figures, while indicative of progress in reducing TB incidence, also underscore the urgency of addressing the persistent challenges that hinder efforts to curb TB mortality.

South Africa's commitment to reducing TB cases by 80% and TB deaths by 90% by 2030, compared to 2015 levels, is a commendable one. The 53% reduction in TB incidence since 2015 is a testament to the concerted efforts of healthcare professionals, policymakers, and community advocates. However, the decline in TB mortality falls short of the milestones outlined by the WHO's End TB Strategy as well as the Sustainable Development Goals.

One of the key challenges highlighted by the latest WHO report is the suboptimal uptake of preventive therapy, particularly among children in TB-affected households. Despite the availability of effective preventive measures, stigma surrounding TB and gaps in healthcare access continue to impede progress. Addressing these barriers requires a multi-faceted approach that encompasses education, advocacy, and investment in healthcare infrastructure. Although there is still an onus on the patient.

Ensuring medication adherence is paramount in effectively managing TB and preventing its spread. Patients must understand the importance of taking their medication exactly as prescribed by their healthcare provider to achieve successful treatment outcomes and minimize the risk of drug resistance.

Additionally, the management of TB involves dealing with various side effects that can arise from the medication. Healthcare providers play a crucial role in educating patients about potential side effects and strategies for managing them. This includes providing guidance on when to seek medical attention for severe side effects and offering practical advice on how to alleviate milder symptoms. Empowering TB patients with knowledge and resources to navigate the complexities of medication adherence and side effect management is essential for optimising treatment adherence and improving overall health outcomes.

In truth, the fight against TB cannot be won through healthcare interventions alone. It requires a comprehensive strategy that addresses social determinants of health, including poverty, inequality, and access to basic necessities such as clean water and sanitation. TB thrives in conditions of overcrowding and poor ventilation, making marginalised communities disproportionately vulnerable to the disease.

To truly end TB, we must prioritise the development of new tools and technologies, including diagnostics, treatments, and vaccines. Investment in research and development is crucial to overcoming the challenges posed by drug-resistant strains of TB and ensuring equitable access to life-saving interventions. Collaboration between governments, research institutions, and pharmaceutical companies is essential to accelerate progress in this field. All of which is entirely possible and feasible.

Tackling TB requires a shift in mindset towards a more holistic approach to healthcare delivery. This includes integrating TB services with existing primary healthcare systems, strengthening community-based care, and empowering individuals to take control of their health. By fostering a culture of prevention and early detection, we can reduce the burden of TB and save countless lives.

On World TB Day, let us reaffirm our commitment to the fight against tuberculosis. Let us honour the memories of those we have lost to this disease by redoubling our efforts to end the TB epidemic once and for all. Together, we can overcome the challenges that stand in our way and build a future where TB is no longer a threat to public health.

While the road ahead may be long and challenging, there is cause for hope. With determination, innovation, and solidarity, we can turn the tide against TB and create a world where everyone has the opportunity to live a healthy and fulfilling life. Yes, we can end TB – but only if we act decisively and with urgency.