Significant progress in tuberculosis fight
South Africa has slashed its tuberculosis incidence rate by 61% as of 2024, marking a watershed moment in the country's long-running battle against the infectious disease. Deputy President Paul Mashatile, who chairs the South African National AIDS Council (SANAC), shared the milestone during the national World TB Day commemoration held at Caledon Sports Grounds in the Western Cape on Tuesday.
Mashatile highlighted that the country has witnessed a consistent year-on-year decline in new TB infections, underscoring the impact of sustained government intervention and public health campaigns. He pointed to treatment outcomes for drug-resistant TB patients as another area of notable improvement, with success rates now standing at 79%.
"We are now seeing a 79% treatment success rate, and for the first time, lost-to-follow-up rates for Drug-Resistant TB are in single digits. This breakthrough is a result of our accelerated efforts in scaling up the introduction of shorter, more effective regimens."
The Deputy President described the progress as cause for celebration, noting that it not only preserves lives but also restores hope across communities. He emphasised that unity, strengthened partnerships and innovation have been instrumental in driving these results forward.
Gaps remain as treatment coverage dips
Despite the encouraging trajectory, Mashatile was candid about the obstacles that still lie ahead. He revealed that the proportion of estimated TB cases successfully placed on treatment had fallen from 79% to 74% over the past year — a development he described as a direct call to action rather than a mere statistic.
On the testing front, the government reached 70% of its ambitious screening target this year. More than 3.5 million tests have been administered since the End TB Campaign was launched during last year's World TB Day in KwaZulu-Natal, representing the highest number ever recorded in a single year for the national TB programme. Mashatile credited the achievement to the dedication of healthcare workers, the resilience of communities, and unwavering partner support.
However, TB continues to be the leading cause of death in South Africa, particularly among people living with HIV. The country has managed only a 17% reduction in TB deaths compared to 2015 — far below the 75% target that was set. Mashatile acknowledged that lives are still being lost unnecessarily and that far greater effort is required to reverse this trend.
"We cannot ignore this human and economic toll. We need to make our response more patient-centred, meeting people where they are and removing all barriers against access to testing and treatment. Early detection is the key to breaking the cycle of infection and protecting families and communities."
The 2021 TB Survey painted an equally sobering picture, revealing that 56% of those affected by tuberculosis in South Africa face catastrophic socio-economic pressures that drive families deeper into poverty. Mashatile stressed the importance of a patient-centred approach that eliminates obstacles to diagnosis and care.
The Deputy President also issued a specific appeal to men, noting that data reveals a disproportionate number of undetected cases among male patients. Although fewer men have been tested over the past 11 months, their positivity rate is considerably higher than other groups.
"Testing more men will help us find those hidden cases and protect everyone."
South Africa's sharp decline in tuberculosis incidence signals meaningful returns on public health investment, yet the disease remains the country's leading killer, disproportionately affecting HIV-positive individuals and pushing families into financial hardship. For businesses, persistently high TB mortality translates to workforce losses and reduced productivity, particularly in mining and labour-intensive sectors. Whether the gains hold will depend on closing the widening treatment coverage gap and reaching undertested populations, especially men, in the months ahead.
