SA Cuts TB Incidence by 61%, But Gaps in Treatment and Mortality Persist

South Africa has recorded a 61% decline in tuberculosis (TB) incidence by 2024, marking a major public health achievement, Deputy President Paul Mashatile announced at the national World TB Day commemorations in the Western Cape.

The milestone reflects sustained efforts under the country's End TB Campaign, though officials cautioned that significant challenges remain in treatment coverage and mortality reduction.

Sharp Decline in New TB Cases

Mashatile highlighted that year-on-year reductions in TB infections signal the success of intensified national interventions.

• 61% reduction in TB incidence achieved by 2024

• Continued decline in new infections annually

• Strong progress in early detection and treatment strategies

"This progress shows that through unity, partnerships, and innovation, we can combat disease and rebuild communities," he said.

Breakthrough in Drug-Resistant TB Treatment

South Africa has also made notable gains in tackling drug-resistant TB (DR-TB):

• 79% treatment success rate achieved

• Lost-to-follow-up cases reduced to single digits for the first time

• Introduction of shorter, more effective treatment regimens

These improvements are seen as critical in addressing one of the most difficult forms of TB.

Record Testing Drive Under End TB Campaign

The government has significantly scaled up testing:

• 3.5 million TB tests conducted since last year's campaign launch

• 70% of testing target achieved

• Highest annual testing volume recorded in the programme's history

Officials credited health workers, community participation, and partnerships for this achievement.

Warning Signs: Treatment Coverage Slips

Despite progress, concerns remain over declining treatment coverage:

• Proportion of TB cases placed on treatment dropped from 79% to 74%

Mashatile described this as a "call to action", urging stronger efforts to ensure that all diagnosed patients receive timely care.

TB Still Leading Cause of Death in HIV Patients

TB continues to pose a major public health threat:

• Remains the leading cause of death among people living with HIV

• Only a 17% reduction in TB deaths since 2015, far below the 75% target

"This gap reminds us that lives are still being lost unnecessarily," Mashatile said.

Socio-Economic Burden Remains Severe

A 2021 TB survey revealed that:

• 56% of affected individuals face catastrophic financial hardship

The government acknowledged the need for a more patient-centred approach, addressing barriers such as:

• Access to healthcare facilities

• Economic vulnerability

• Delayed diagnosis and treatment

Focus on Early Detection and High-Risk Groups

Authorities emphasised that early detection is key to breaking transmission cycles.

Mashatile made a specific appeal:

• Men to come forward for testing, as they represent a large share of undiagnosed cases

• Close contacts of TB patients to seek immediate screening and preventive therapy

"Testing more men will help us find hidden cases and protect communities," he said.

Renewed Push to Close Gaps

While South Africa's TB programme has made significant strides, the government is now focusing on:

• Improving treatment coverage

• Reducing mortality rates

• Expanding preventive care and early diagnosis

• Strengthening community-based interventions

Towards Ending TB

The progress achieved demonstrates that large-scale public health interventions can yield results, but officials stress that sustained effort and targeted action are essential to meet national and global TB elimination goals.