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World TB Day: 25% of all TB cases are in Africa, and so are the deaths

The First National TB Prevalence Survey from 2018 indicates that South Africa is one of the 30 nations with a high burden of tuberculosis (TB), accounting for 87% of the estimated incidence. On its own, SA accounts for 3% of all TB cases worldwide.

South Africa continues to be negatively impacted by TB, which is a cause for serious concern. It has the highest incidence rate of TB in Africa, with approximately 301 000 cases annually. TB also remains among the leading causes of death for those infected with HIV.

In commemoration of World TB Day, the theme for 2023 is “Yes! We can end TB!” which looks at how TB is preventable and curable. Sadly, Africa continues to be plagued by tuberculosis, as a staggering 10 million individuals succumb to the disease each year.

There are various reasons for the high incidence rate of TB in South Africa and Africa as a whole. Poverty, overcrowding, and malnutrition are some of the factors that contribute to the high prevalence of the disease. Additionally, cultural beliefs and a lack of awareness can lead to those infected with TB not seeking medical attention, thus increasing the risk of the disease spreading.

Why treatment is vital

One of the most significant challenges in treating TB is the lengthy period it takes to cure the disease – up to 6 months of daily medication. The risk of drug-resistant TB also increases if the medication is not taken correctly or if treatment is interrupted.

Effective treatment is essential, not only for the health of the individual but also to prevent the spread of TB within communities. Early diagnosis, successful treatment, and social support are all critical factors in managing TB.

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Strides made in the treatment

Although, there have been significant advances in TB treatment in recent years, including the development of new drug regimens and diagnostic tools. South Africa has implemented a comprehensive TB control program, including the provision of free treatment and care, increased laboratory capacity, and the use of community healthcare workers to reach remote areas.

The reality in Africa

TB is the largest cause of death from a single infectious agent, according to Dr Allan Pamba, Executive Vice President, of Roche Diagnostics.

Further, 25% of all TB cases, as well as 25% of all deaths, occur in Africa.

“Africa’s HIV burden causes further complications, as those infected with HIV are 18 times more likely to develop TB. The conditions form a lethal paradox, both accelerating the development of the other.”

And 85% of TB patients in Africa are also HIV positive. Despite the stark reality, however, according to the World Health Organization (WHO), “Funding for TB prevention, diagnosis, and treatment services continues to fall far short of estimated global needs and the United Nations global target. In 2020, global spending on TB services fell to $5.3 billion, and funding for research was $901 million,” said Dr Pamba in a statement.

He goes on to bring to attention that the most affected nations in Africa share the desire to eradicate tuberculosis, but funding mobilisation has lagged. Only 22% of the funds required to offer effective TB services in Africa are provided by the government, and 44% are still unfunded. This severely hampers efforts to lessen the TB burden.

Changing the narrative

“Without diagnostics, there can be no treatment. High-quality diagnostics are the cornerstone of any clinician’s arsenal against disease. But presently, primary care medical facilities in many developing nations have significant gaps in access to critical diagnostic tools.

To quote the WHO, “Ending TB is not just a public health problem, but a development challenge and opportunity,” said Dr Pamba.

While there is still much work to be done to address TB in South Africa, there is hope that with continued efforts, the disease can be eliminated. Treatment is vital, and with the right medical care, support, and awareness, we can end TB in our lifetime.

Read the latest issue of IOL Health digital magazine here.

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