South Africa makes progress in TB reduction, but mortality and inequality persist.
CAPE TOWN, SOUTH AFRICA: 18 NOVEMBER 2025: The latest Global TB Report 2025 shows that South Africa has achieved a 61% reduction in TB incidence between 2015 and 2024, marking a significant milestone in the national fight against one of its deadliest yet preventable diseases(1). However, the country continues to grapple with persistent mortality, which has declined by only 17% over the same period, underscoring the urgent need for sustained, equitable and integrated health interventions(1).
For South Africa, according to the World Health Organization, approximately 249,000 people developed TB in 2024, including about 14,000 cases of drug-resistant TB. An estimated 54,000 people died from TB-related causes, of which 29,000 occurred among people living with HIV(1). TB remains South Africa’s leading cause of death from a single infectious agent and continues to be compounded by high HIV prevalence and socio-economic inequities. The strong interlink between HIV and TB continues to shape the epidemic. People living with HIV are at least 18 times more likely to develop active TB compared to those who are HIV-negative, and over half of all TB patients in South Africa are HIV co-infected. This intersection demands integrated, community-led responses that address both diseases concurrently.
Attending the recently held TB Summit in Khayelitsha, Cape Town, Professor Harry Hausler, CEO at TB HIV Care stated, “The dual epidemics of TB and HIV are deeply intertwined and rooted in inequality. To achieve meaningful change, our response must be people-centred, community-driven and sustained.” Prof Hausler highlighted several important innovations in TB control that South Africa is implementing including TB nucleic acid amplification tests (TB-NAAT) and TB LAM for TB diagnosis, shortened 3-month regimens for prevention of TB, 4-month treatment regimens for uncomplicated TB in children and 6-month all oral treatment regimens for multi-drug resistant TB.
While the national incidence trend reflects progress, provincial disparities remain stark. Four provinces, Eastern Cape, KwaZulu-Natal, Gauteng, and Western Cape, accounted for 77% of laboratory-confirmed pulmonary TB cases in 2024. The Eastern Cape continues to report the highest notification rate at 703 cases per 100,000 population, compared to markedly lower rates in provinces such as Limpopo(2).
TB HIV Care strengthened its integrated care approach during the 2024/25 reporting period, delivering high-impact TB and HIV services across 40 districts in all nine provinces and reaching more than 1.09 million people with HIV testing services. The organisation supported 27,873 clients to start antiretroviral therapy (ART) and achieved an impressive 95% viral suppression rate among those in care. As part of its TB-focused initiatives:
- 658,382 people were screened for TB,
- 12,594 individuals were tested, of whom 407 tested positive and were referred for treatment.
TB HIV Care also implemented Targeted Universal Testing for TB (TUTT) to improve early detection among high-risk households and worked closely with the Western Cape Department of Health to expand community-oriented primary care models that integrate TB, HIV, and wellness services at the community level. The organisation is expected to release its official 2024/25 Annual Report later in November 2025.
“We remain steadfast in our commitment to ensure that no one is left behind in the fight against TB and HIV. Through deepened collaboration with government, civil society, and the communities we serve, we are advancing a public health response that is inclusive, resilient, and equitable. These partnerships are transforming access to care, particularly for key and vulnerable populations, and reinforcing our collective resolve to end these epidemics,” said Dr Memory Muturiki, TB HIV Care Chair of the Board
TB HIV Care continues to advocate for equitable access to TB and HIV prevention, testing, and treatment, while addressing the social determinants of health, including poverty, stigma, and limited access to healthcare. The organisation’s integrated approach aligns with the National Strategic Plan for HIV, TB and STIs (2023–2028) and supports South Africa’s pursuit of the WHO End TB Strategy.
As South Africa strives to eliminate TB as a public health threat by 2035, the combined strength of government, non-profits, and communities will be essential to overcoming the final barriers, ensuring that progress in incidence is matched by reductions in mortality and inequity.
References:
- World Health Organization (2025). Global Tuberculosis Report 2025. Geneva: WHO. Access.
- Department of Health, South Africa (2024). National TB Surveillance and Provincial Notification Data. Access.
Issued by:
- Aziel Gangerdine
- TB HIV Care, Spokesperson
- E-mail: aziel@tbhivcare.org
- Cell: +27 (0) 66 545 6053
ENDS.
TB HIV Care
TB HIV Care is a registered non-profit company (NPC) that puts integrated care at the heart of responding to TB, HIV, and other major diseases. We work to prevent, find and treat TB and HIV in South Africa as well as targeting our interventions to address the needs of populations most at risk, including communities in the Eastern Cape and Western Cape, adolescent girls and young women in KwaZulu-Natal, inmates in correctional centres, sex workers and people who inject drugs.
