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Health Minister Joe Phaahla has revealed that South Africa is still the epicentre of the Aids pandemic, with skyrocketing infections.
Phaahla revealed this at the 11th health conference held in Durban on Tuesday.
"South Africa is on the three global lists of high-burden countries for TB, HIV-associated TB, and drug-resistant TB. The World Health Organization (WHO) estimates that over 110 000 people with TB in South Africa lost their lives between 2020 and 2021," he said.
Phaahla said since 2010, over one million South Africans were estimated to have succumbed to TB, which is preventable and curable.
The health minister also said the Covid-19 pandemic and associated lockdowns severely impacted TB services throughout the country. He added:
Phaahla said after extensive consultation with all stakeholders, the health department developed the TB recovery plan.
The TB recovery plan is a target-driven, evidence-based plan aimed at finding people with undiagnosed TB, strengthening the linkage of people diagnosed with TB to treatment, strengthening retention in TB care and strengthening TB prevention.
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He said South Africa was at the forefront of TB research and development. There were some new interventions and exciting developments, including expanded screening activities with TB health checks, as well as the use of digital chest X-rays for TB screening.
"For the people with undiagnosed TB, we plan to screen a million people, 60% PLHIV tested and notification of 215 900 patients through annual TB tests. This will be augmented by 300 000 chest X-rays screening. We will also introduce TB results notification system to patients via SMS to improve linkage to treatment. We will soon be using new molecular diagnostic tests for TB," he added.
He mentioned the department planned to put 85% of the lab-diagnosed patients on treatment, and wished to retain 86% of the drug-susceptible TB on treatment through strict adherence to treatment programmes.
He stated the department further wanted to scale up the implementation of new TB preventive therapy, including 3HP (three months of weekly rifapentine and isoniazid oral treatment) to improve TB-prevention and reduce transmission, especially among household contacts.
"Through the implementation of the TB recovery plan, we are starting to see improvements in TB testing, notification and TB incidence. The number of GeneXpert tests done in 2019 was just over two million and decreased to 1.5 million due to Covid-19 in 2020. Since then, we have observed some recovery in TB testing, with 1.9 million tests done in 2021 and 2.5 million tests in 2022, which gives us signs that indeed this recovery plan will take us back to where we were before the pandemic. In this regard, we are proud to report that between 2009 and 2021, the estimated TB incidence has decreased from 644 000 to 304 000."
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The department also reported that TB notifications increased from 187 735 in 2021 to 226 689 in 2022.
"We exceeded our 2022 target of 215 900. These trends are consistent and robust and provide encouraging evidence that we are on track to meet global targets, because that is where we best compare ourselves with other countries in the world. We intend to move even faster and further to ensure that we fully recover losses suffered."
Based on 2021 estimates, we are on track to meet the WHO target for a reduction in TB incidence rate in 2025 of 50%; and we are also likely to meet the 2030 SDG target of 80% reduction in TB incidence rate. We await the Tembisa modelling to provide the latest estimates of TB incidence. We recommit to continue to accelerate the decline of TB incidence and to achieve this, we must double our effort in finding TB to end TB. That is why we are reprioritising communication and advocacy to create demand for TB testing.
The ministry said HIV, TB and STIs NSP, and the integration of TB and HIV services were opportunities to improve patients' experience.
Phaahla added:
Phaahla also mentioned he was pleased that the NHI bill had now proceeded to the National Council of Provinces.
"A vote will be taken today (Tuesday), after which we will enter an interesting phase of lives in health system management. NHI aspires to a strong national health system, buttressed by a viable district health system that invests its resources in PHC services, clinics well run and embedded in the PHC system across the health system. A strong PHC system means strong TB and HIV services, strong health services closest to our people," he said.
He said the recommendations of the TB Indaba will provide an opportunity to strengthen the implementation of the TB recovery plan 2.0 in that kind of a system where PHC was the focus of our attention for the delivery of health services.
These outcomes will be aligned with the recently launched national strategic plan for HIV, TB and STIs for 2023-2028. South Africa has a critical mass of world-renowned TB experts, clinicians and researchers, and a very integrated multi-stakeholder community, which together form a great force, which when properly managed and coordinated, can achieve the results with a goal of ending TB by 2035.
