Sound the alarm! The clock is ticking: let’s prevent, find and end TB!

In support of the national theme for World TB Day 2021 The clock is ticking to find, treat and end TB, TB HIV Care is asking the country, to “sound the alarm. Raise your voice and make a noise to show that time is running out to meet our commitments to end TB.”

We’re asking you to commit to sound the alarm by signing an online pledge committing to:

  • Setting your phone or watch alarm to go off at 08h00 from 17th to 24th March
  • Blowing a vuvuzela at 08h00 from 17th to 24th March
  • Hooting your car at 08h00 from 17th to 24th March

In 2018, South Africa made commitments to meet certain TB targets by 2022 at the United Nations High-Level Meeting (UNHLM) on TB. With less than two years left to fulfil them, the clock is ticking. With the advent of the COVID-19 pandemic, TB has slipped back down the global health agenda, while simultaneously severely impacting on the delivery of TB-related health services. The National Institute of Communicable Diseases (NICD) noted a 30% drop in TB diagnosis in the first five months of the COVID-19 pandemic in the country. In a context where 42% of people sick with TB were already not being diagnosed and treated, this is seen by many as a crisis.

An important aspect of the 2022 UNHLM targets is a show of political leadership and coordination in the country by the formation of a multisectoral accountability framework for TB (MAF-TB). The clock is ticking to set up such a mechanism in South Africa, which could then ensure progress towards the other critical targets.

This campaign aims to sound the alarm on TB as a public health emergency and focus attention on the countdown to meeting South Africa’s targets to End TB.

For media enquiries: Alison Best 072 615 9192

Stop TB Partnership World TB Day 2021 toolkit

SANAC World TB Day 2021 toolkit

All you need to know about the COVID-19 vaccine

Vaccination has saved millions of lives and is one of the most successful public health interventions the world has ever seen. Vaccinating our children is one of the key acts we as parents take to ensure their health.

Many people have questions about the new COVID-19 vaccine that has just arrived in South Africa and will begin to be offered to health care workers in phase one of three phases.

The National Department of Health has developed excellent resources to answer these questions. We’ve extracted some below, but the full version and even more resources are available here.

What is a COVID-19 vaccine?

A vaccine is intended to provide immunity against COVID-19. In general, vaccines contain weakened or inactive parts of a particular organism that triggers an immune response within the body. This weakened version will not cause the disease in the person receiving the vaccine, but it will prompt their immune system to respond. Some vaccines require multiple doses, given weeks or months apart. This is sometimes needed to allow for the production of long-lived antibodies and development of memory cells. In this way, the body is trained to fight the specific disease-causing organism, building up memory against the pathogen so it can fight it in the future.

What is herd immunity?

When a lot of people in a community are vaccinated, the pathogen has a hard time circulating because most of the people it encounters are immune. So the more that others are vaccinated, the less likely people who are unable to be protected by vaccines are at risk of even being exposed to the harmful pathogens. This is called herd immunity. But no single vaccine provides 100% protection, and herd immunity does not provide full protection to those who cannot safely be vaccinated. But with herd immunity, these people will have substantial protection, thanks to those around them being vaccinated. Vaccinating not only protects yourself, but also protects those in the community who are unable to be vaccinated.

What process is followed before a vaccine is given to the public?

Before COVID-19 vaccines can be delivered: 1) The vaccines must be proven safe and effective in large clinical trials. 2) A series of independent reviews of the efficacy and safety evidence is required. 3) The evidence must also be reviewed for the purpose of policy recommendations on how the vaccines should be used. 4) An external panel of experts convened by WHO, called the Strategic Advisory Group of Experts on Immunization (SAGE), analyzes the results from clinical trials. 5) The panel then recommends whether and how the vaccines should be used. 6) Officials in individual countries decide whether to approve the vaccines for national use and develop policies for how to use the vaccines in their country based on the WHO recommendations.

What steps are taken to ensure the COVID-19 vaccine is safe?

COVID-19 vaccines go through a rigorous, multi-stage testing process, including large trials that involve tens of thousands of people. These trials, which include people at high risk for COVID-19, are specifically designed to identify any common side effects or other safety concerns. Once a clinical trial shows that a COVID-19 vaccine is safe and effective, a series of independent reviews of the efficacy and safety evidence is required, including regulatory review and approval in the country where the vaccine is manufactured, before WHO considers a vaccine product for prequalification. An external panel of experts convened by WHO analyzes the results from clinical trials, along with evidence on the disease, age groups affected, risk factors for disease, and other information. The panel recommends whether and how the vaccines should be used.

Are vaccines necessary to prevent the spread of COVID-19?

There is overwhelming scientific evidence that vaccination is the best defence against serious infections. Vaccines do not give you the virus, rather it teaches your immune system to recognise and fight the infection. The COVID-19 vaccine presents the body with instructions to build immunity and does not alter human cells. Vaccine have reduced the morbidity and mortality of infectious diseases such as smallpox, poliomyelitis, hepatitis B, measles, tetanus, whooping cough and pneumococcal conjugate across the world. Vaccinating enough people would help create herd immunity and stamp out the disease.

Are vaccines safe to use?

Vaccines undergo rigorous trials to ensure they are safe and effective. All vaccines go through a comprehensive approval process by medical regulators to ensure that they are safe. Pharmaceutical companies hand over all laboratory studies and safety trials to validate that the vaccine does work. Any safety concerns are picked up by regulators when reviewing the data. Vaccines are made to save lives – not to oppress, bewitch, possess or indoctrinate people.

Where is South Africa getting its first vaccine from?

South Africa will receive 1 million doses of the COVID-19 vaccine in January and 500,000 doses in February of the Oxford University-AstraZeneca vaccine from the Serum Institute of India (SII).

Who will get the COVID-19 vaccine first?

We will begin by vaccinating our country’s estimated 1.25 million healthcare workers.

How do we make sure COVID-19 vaccines are safe?

Government is working closely with South African Health Products Regulatory Authority (SAHPRA) to ensure there is no delay approving the vaccine for use. The Oxford University-AstraZeneca vaccine has already been approved by various regulators around the world and is being rolled out in other countries.

Who are our other vaccine suppliers?

We have also reached an agreement with the COVAX Facility to secure vaccines to immunise 10% of the population. These doses are expected at the beginning of second quarter of the year and we continue to work with various pharmaceuticals companies to ensure we immunise 67% of the population by the end 2021.

Was there a deliberate delay in acquiring a COVID-19 vaccine for South Africans?

There has been no deliberate delay to access the COVID-19 vaccine, as the situation remains fluid; all factors have to be taken into account. We are selecting vaccines on their safety and efficacy, ease of use, storage, distribution, supply sustainability and cost.

How will the vaccine be distributed?

Our rollout of the vaccine will take a three-phase approach that begins with the most vulnerable in our population. Our target is to vaccinate 67% of the population by the end of 2021, which will allow us to achieve herd immunity.

  • Phase 1 will focus on frontline healthcare workers
  • Phase 2 will vaccinate essential workers, persons in congregate settings, persons over 60 years and persons over 18 years with co-morbidities.
  • Phase 3 will focus on persons older than 18 years, targeting 22,500,000 of the population.

Who is purchasing the COVID-19 vaccine for South Africa?

Government will source, distribute and oversee the rollout of the vaccine. Government as the sole purchaser of vaccines will distribute it to provincial governments and the private sector. A national register for COVID-19 vaccinations will be established. The vaccination system will be based on a pre-vaccination registration and appointment system. All those vaccinated will be placed on a national register and provided with a vaccination card. A national rollout committee will oversee the vaccine implementation in both the public and private sectors.

Extracted from “All you need to know about COVID-19 and vaccines: A complete guide” South African National Department of Health. 2021

More resources

Request for Proposals: CXR Software


South Africa has one of the highest burdens of TB in the world. Approximately 1% of the population develop active TB disease annually. This has informed a decision by the Global Fund Cluster within NDoH to procure computer-aided diagnosis (CAD) software through three sub recipients namely: TB HIV Care, AQUITY Innovations, and Isibani Development Partners.

NDoH through TB HIV Care is seeking a service provider to provide CAD software for chest X-ray TB screening across 16 community based X-Ray Containers to reach an estimated 620 000 clients by March 2022 in six TB priority districts (City of Cape Town, Ekurhuleni Health District, Johannesburg Health District, Ehlanzeni, eThekwini and OR Tambo).

The National Department of Health (NDOH) has appointed TB HIV Care NPO, to advertise the tender on behalf of the grant. All communication pertaining to the tender will be handled by TB HIV Care.

Tender Reference Description Closing Date

THC/NDOH 10/2020-05

Appointment of a service provider to provide:

§  CAD for TB

§ Real-time CXR management system

§ Cloud-based solutions to store and archive DICOM

§ Central radiologist reporting service

21 October 2020


The full Terms of Reference and additional detailed technical specifications can be downloaded here. All applicants are encouraged to review these to inform their applications as they are critical for application purposes. Interested parties are invited to submit enquiries to No response to queries will be actioned three days prior to the closure of the bid – 18 October 2020 (17:00pm). Responses to all enquiries will be posted on the TB HIV Care website ( on 19 October 2020 (11:00am) to promote equal provision of information.


For further enquiries, please contact TB HIV Care at 082 555 7341 by 18/10/2020.

Queries and Answers: 

  1. What will be the opening hours of the 16 containers (during which CXRs will be made and have to be reported on)?

The 16 containers will operate according to South African facility hours – some facilities deliver services for 8 hours (08:00 to 16:30) of the day while others deliver a 24 hour service.

2. How many weeks per year will the containers be operating making X-rays?

DCXR containers will be operational for 50 weeks of the year. We have a 2 weeks holiday break from the 16th of December to the 02nd of January.

3. How long will the project be running to screen the projected 620 000 people?

The Digital Chest X-ray programme will be operating until the end of our funding period which is March 2022.

4. How many CXRs will be made in the total of the 16 container per week? Please stipulate the minimum and maximum to be expected.

The minimum amount of CXRs – 400 with a maximum of 600 CXRs per week across the 16 containers.

5. Can you please share your protocol/SOPs? E.g. will sputum be collected on-site and will that be analysed by GeneXpert machines in the containers?

Draft SOP is currently with the National Department of Health of South Africa and will be shared once software tender has been concluded and a service provider appointed.

6. On page 3 of the tender document at 2. X-rays management system the requirement is: ‘Customize according to needs of SRs’. Can you elaborate on what is meant please? 

Each SR (Subrecipient) has specific needs under this grant. An SR might want to segregate daily data into age and gender whilst another would want to segregate in another way. The system thus needs to be adaptable when it comes to different M&E tools.

7. Can you please explain what the ‘Categories A, B and C’ mean at the financial capabilities page 7 of the tender document?

Point 7 refers to the financial feasibility of the bidder – according to bank rating / scoring.

8. On page 5 the tender document says at 5 Special conditions: all pages of the bid must be initialed. We assume that this does not apply to financial statements and other supporting documents, is that correct? It would create unnecessary huge files.

Yes, that is correct. Only the official tender documents can be initialed.

9. The closing date for submission is 21 October. Is that also at 17.00pm? 

Tender documents will only be opened the next day which is the 22nd, so no specific time for the closure.

10. We can submit enquiries to Do we also submit the bids to this address?

Yes, please send your bids to the same email address.

11. How many concurrent users for the central radiologist reporting service.

This will vary according to the usage across all sites.

12. Are the total number of studies 620K for two years? Please confirm.

Yes the total number of studies are 620 000 until grant period ends – which is end March 2022.

13. In the document, it is mentioned that they need storage for 7 years, who will provide the storage?

The storage needs to be part of the software package during the grant period – till March 2022 – thereafter it needs to be accessible for migration to another database hosting service.

14. What is the link bandwidth between the mobile clinics and the data center?

Bandwidth link of 20MB per second will be ideal for this project.

15. How many years are required for warranty?

The warranty has to be valid till at least March 2022 when the grant period ends.

16. Regarding the required AI, is it for the mobile clinics or the central radiologist reporting service?

AI has to be part of the software for the mobile clinics – Radiographers on site will use AI to determine whether a client is presumptive of TB or not. Presumptive clients have to be referred for sputum collection in order to be diagnosed. Radiologist will not be on site – images will have to be sent to the remote radiologist.

17. In the document, it is mentioned that there are a total of 16 X-Ray machines, Please confirm.

Yes, a total of 16 containers, thus 16 X-ray units.