As the globe marks World TB Day, in South Africa, a new report has highlighted what needs to be done to reduce the country’s massive TB burden. 

At the centre of the 2024 State of TB in South Africa Report are calls for the government to get more men on treatment and to find ways that integrate TB, HIV and diabetes services to offer one stop treatment.

The report, titled What about TB Mortality?, also calls on the government to review its screening protocols for TB and to introduce preventative treatment for people at risk of getting TB. Released on World TB Day each year, it explores the reasons for South Africa’s relatively high TB infection and death rates. It also looks at what can be done to change the trajectory of this treatable and preventable disease. Currently in South Africa, 54 000 people die from TB each year while another 280 000 people are infected. 

But according to the report, to reduce the high prevalence of TB in South Africa’s communities, the country must introduce better initiatives that improve the number of men who are tested and treated for TB as well as improve interventions that target people who are living with HIV and TB, as well as TB and diabetes.  

According to a study quoted in the report, there were 1.7 times more TB deaths among men than among women. “It is thought that the discrepancy between TB deaths in men and women is due in part to factors such as men’s lower participation in HIV-related services, lower TB testing rates, poorer adherence to TB treatment and higher rates of loss to follow-up than women,” noted the report. Higher levels of smoking and drinking among men also play a role.

TB also remains the leading cause of death in people living with HIV. While South Africa has seen a reduction in the number of HIV-positive people dying from TB, according to the report, more than 50% of people who die from TB have HIV. “These individuals are at a much higher risk of progressing to TB illness because of their compromised immune systems,” notes the report. 

And separately, the report has highlighted how diabetes increases patients’ susceptibility to TB, worsens their TB treatment outcomes, and leads to more deaths, treatment failures and recurrent disease. In South Africa, diabetes is the second general leading cause of death.

One of the recommendations in the report is to integrate TB, HIV and diabetes services to address the interconnectedness of these diseases by offering combined screenings and one-stop treatment access and monitoring.

The report has also called for better TB screening protocols and more widespread use of preventative treatment for people at risk of getting TB. It highlighted that large portions of TB patients are asymptomatic and are missed in the current screening methods. 

The report, released by the TB Accountability Consortium on World TB Day each year is the third of its kind and is in line with global health bodies’ calls to #EndTB.

Report by TB Accountability Consortium