Southern Africa remains one of the regions most affected by tuberculosis (TB), with countries such as South Africa and Mozambique still bearing a significant share of the global disease burden. Experts say that although some progress has been made, much more still needs to be done to reduce infections and deaths.
South Africa remains a global hotspot for TB. According to the World Health Organization (WHO), an estimate 54,000 people will die from this disease in 2024. And while the figure is lower than in previous years, experts warn that the pandemic is far from over.
“There is definitely a greater burden on South Africa due to co-HIV infection [rates]Helen Hallström, senior partnership officer for ADPP Mozambique, told DW.
With a co-infection rate of 54% among people living with HIV, the country is listed among the top 30 high-burden TB countries in the world.
“People who are living with HIV often have a suppressed immune system if they are not following treatment,” Hallstrom said.
Unknown cases in Mozambique
Mozambique is also facing a TB crisis. In 2023 alone, an estimated 112,000 people will contract the airborne disease, yet approximately 17,400 cases remain undiagnosed, reflecting ongoing barriers to accessing care. Furthermore, the southern African nation has Have been battling drug-resistant TB (DR-TB) for a long time.
Despite being preventable and curable, TB remains one of the leading causes of death in Mozambique, especially among people living with HIV. Like South Africa, the country is among the top 30 high TB-burden countries in the world. Hallstrom said economic disparities play an important role. “We also have severe malnutrition and many people still live in poverty [are] “That’s part of what’s driving it,” he said.
In addition to HIV, malnutrition, drug-resistant TB (DR‑TB), stigma and discrimination, weak health care systems also prevent many people from seeking timely diagnosis and treatment. Experts advise that early diagnosis and adherence to treatment are important to fight the pandemic. “Weak health systems, which impact late diagnosis, are undermining progress,” Hallstrom said.
A patient in Johannesburg told DW that he only realized his TB status after being admitted to hospital due to feeling unwell. “When I came back for the results, they told me I had TB, but when they told me I had TB, I started having symptoms like sweating, I couldn’t eat and I lost a lot of weight,” she said.
recognizing early symptoms
Health professionals say infections are increasing due to limited knowledge. “When you start losing weight, you start coughing, some people may think they have some allergies, and you get night sweats. These are the most common symptoms…some [people] “There is TB but there are no immediate symptoms,” Hallstrom said.
In South Africa, activists, health workers and government officials have stepped up a campaign to encourage testing and treatment. “[We are] To encourage individuals to take responsibility for their own lives. “Year after year, we are seeing a steady decline in the number of people infected with TB,” Vice President Paul Mashatile said at an event to mark World TB Day on March 24. “Our national TB program has achieved remarkable success in reducing the TB incidence rate, which is the number of new cases each year,” he said.
Experts say both countries should train more community communicators to spread awareness about TB.
In Mozambique, 67-year-old community leader Modesta Antonio has become an influential voice even without a medical background. Trained through a local health initiative, she is now one of the most effective TB teachers in her district. Hallstrom said such efforts are highly effective in encouraging testing and treatment.
Digital tools help fight stigma and improve access
Along with education and treatment programs, digital innovation is proving valuable in helping change mindsets about the disease. “The stigma is very high among people. By making sure people have more information to know what TB is and how you can prevent it [is key]” Hallstrom insisted.
His organization uses the OneImpact platform, a community-based monitoring app developed by the Stop TB Partnership, which is active in more than 23 countries. Local communicators receive training in using the platform, which provides low-cost socio-technology support. In Mozambique, the app has enabled TB patients to report discrimination, understand their rights and stay connected to care.
Its first formal evaluation in the African context found the platform to be highly acceptable and linked to improved provider communication, treatment adherence and awareness of rights. Despite ongoing challenges, Southern Africa has made significant progress in reducing TB infections and deaths. According to WHO, TB deaths across Africa are expected to fall by 42% between 2015 and 2023 due to better integration of HIV treatment. Hallstrom said this shows real potential to eliminate TB.
“Progress is being made and it’s also because of strong community engagement. So communities are taking ownership and working on local solutions [will help us] End TB,” she said.
This article was compiled from materials Africalink Podcasthosted byeddie micah jr.
Edited by: Crispin Mavakideau