TB remains the leading cause of death among people living with HIV, accounting for 54% of all TB cases in the country.
Image: Supplied
Despite progress made in reversing pre-pandemic trends in the fight against TB, and awareness campaigns that have improved knowledge about TB, stigma remains a major barrier with many people still associating it with poverty, HIV, or personal neglect, leading to discrimination.
This was voiced by Patrick Mdletshe, the Head of Community Programmes at the Centre for the AIDS Programme of Research in South Africa (Caprisa), and who is also the Deputy General Secretary of the Treatment Action Campaign (TAC).
Mdletshe said, “While awareness campaigns have improved knowledge about TB, stigma remains a major barrier. Many people still associate TB with poverty, HIV, or personal neglect, leading to discrimination. The World TB Day 2025 theme, “Yes! We Can End TB: Commit, Invest, Deliver”, aims to address this issue, but more grassroots engagement is needed. We need community-driven campaigns where TB survivors share their experiences, breaking myths and encouraging early diagnosis.”
He said the intersection of TB and HIV in South Africa presents a major public health challenge, although TB is preventable and curable.
“TB remains the leading cause of death among people living with HIV (PLHIV), accounting for 54% of all TB cases in the country. The need for integrated TB-HIV treatment is critical, yet challenges such as drug interactions, pill burden, and healthcare system inefficiencies continue to hinder effective treatment. From a community perspective, access to consistent and uninterrupted treatment is a major issue, particularly in under-resourced areas where clinic stockouts, transport costs, and long waiting times prevent people from adhering to treatment” Mdletshe said.
He highlighted the devastating social and economic consequences of TB, particularly for marginalised communities, where many patients lose their jobs due to prolonged illness, resulting in economic hardship.
“The stigma associated with TB often isolates patients, discouraging them from seeking care. Families of TB patients also suffer financially, as caregiving responsibilities disrupt income-generating activities. From our work in the community, we see how poverty, malnutrition, and overcrowded living conditions create a vicious cycle, making TB both a cause and a consequence of socio-economic inequality,” he said.
On progress made in TB prevention, diagnosis, and treatment, he said TB incidence has dropped by 57%, exceeding the 2025 target and more than 2.9 million people were tested for TB in 2024, reversing pre-pandemic trends.
He added that South Africa is leading in adopting new TB drugs, such as the six-month regimen for drug-resistant TB.
“Areas that need attention include finding the “missing” 48,000 people with TB who remain undiagnosed. Reducing TB mortality, as deaths remain high despite treatment advances and better service integration between TB and HIV programs,” Mdletshe said.
He added that Caprisa is actively involved in epidemiology, prevention, and treatment research for TB, focusing on vulnerable populations, particularly women and girls, with key initiatives including; TB and HIV co-infection studies, improving understanding of disease progression, testing new TB vaccines and treatment regimens, particularly shorter drug-resistant TB treatments and community-based TB screening models, bringing diagnosis closer to homes.
He said the reduction of Pepfar funding has impacted TB and HIV services, particularly in community-based interventions and treatment access, and many programs reliant on international donor funding are struggling to sustain outreach and care initiatives.
He added that there is a need to enhance efficiency in resource allocation, prioritising high-burden areas, strengthening local funding mechanisms, pushing for increased government investment, and expanding partnerships with private sector donors.
Mdletshe said the TAC continues to advocate for improved access to TB testing and treatment, particularly in rural and informal settlements, and the integration of TB and HIV services to ensure seamless care, among other things.
A study by Stellenbosch University’s Desmond Tutu TB Centre which assessed lung function in adolescents with TB during anti-TB treatment and after treatment completion found that lung problems persist in most adolescents even after TB treatment.
“Our data suggests that a large proportion of adolescents have impaired lung function following successful TB treatment completion. Strategies are required to identify individuals at risk for respiratory morbidity and interventions are needed to improve lung health after TB,” Stellenbosch said.
The university added that studies have shown that even mild impairment of lung function is associated with increased risk of heart and lung issues later in life, or even premature death.
“As a result, our data shows that adolescents that had TB are at risk of permanent long-term heart and lung problems,” it said
The World TB Day is commemorated annually on March 24, to build public awareness about the global epidemic of tuberculosis and profile efforts to eliminate the disease. It is also aimed at highlighting the health, social and economic impact of TB.
South Africa remains amongst countries hardest hit by TB, which has remained the leading cause of death claiming around an estimated 56 000 lives a year, more than half (54%) of which are people living with HIV.
The Department of Health, led by Minister Dr Aaron Motsoaledi said the significance of this year’s commemoration will be marked by the launch of the National End TB campaign designed to substantially reduce TB incidence and mortality in South Africa by 2035. This campaign will be implemented in phases, starting with a focus on Case Finding and Linkage to care in the year 2025/2026.
“The campaign also aims to diagnose 250,000 new TB cases in 2025/26 through targeted testing of 5 million people. This will be achieved by implementing Accelerated Targeted Universal TB Testing (TUTT) to reach people living with HIV and household contacts of confirmed TB cases,” the department said.
On Monday, deputy president Paul Mashatile, will deliver the keynote address at the national World TB Day commemorative event, and launch of the National End TB Campaign at the Ugu Sports & Leisure Centre, on the south coast of KwaZulu-Natal. He will be joined by the Motsoaledi and KwaZulu-Natal Premier Thamsanqa Ntuli amongst others.
gcwalisile.khanyile@inl.co.za