Accountability for TB policy implementation (2022-2025)
South Africa’s National TB Recovery Plan and National Strategic Plan for HIV, TB and STIs 2023-2028 (NSP) describe key strategies to end TB in our communities.
Now, TB guidelines outline that all close TB contacts, people living with HIV, and people with previous TB (in the past two years) should get tested for TB.
If they test positive, they must start TB treatment without delay. If they test negative, they should take TB Preventive Therapy (TPT) for protection against TB Infection progressing to TB disease.
Yet, these services are not always accessible, acceptable and of high quality. Local community leaders are uniquely positioned to raise awareness of new guidelines at the community level to create demand for these services and to play a role in community-led monitoring to hold the Department of Health accountable for policy implementation.
Vision
To support the effective implementation of the TB Recovery Plan and National TB Strategic Plan (NTP).
Aim
Effective implementation of the TB Recovery Plan and National TB Strategic Plan (NTP).
Achievements
Community-based demand creation for TB testing
TB Proof is positioned as a trusted community engagement partner and co-developed multiple TB pamphlets and posters which were endorsed, printed and distributed by the Western Cape Department of Health & Wellness on TB care, including testing, reaching over 10 000 people. Champions co-developed a “ThinkTB” campaign engaging with the community through multiple in-person events, social media and traditional media with the aim of increasing TB testing.
The TB Champion Mentorship programme
TB Proof worked closely with 11 local community leaders as part of a TB mentorship programme (July 2023-August 2025). TB champions in Delft demonstrated increased leadership and advocacy skills by initiating multiple local TB testing and awareness raising events where they secured buy-in from partner NGOs to provide TB testing services on-site.
TB champions set collective advocacy priorities and presented an advocacy letter to the Delft Community Health Centre facility manager in March 2025, resulting in invitations to attend health facility team meetings to strengthen the TB response at facility-level.
The project contributed to a drop in test positivity rate at the two TB champion intervention sites. A video was commissioned to showcase the impact of the Delft TB champions’ work (access here).
Policy maker engagement to increase TB testing, treatment and prevention
- Advocacy letters
TB Proof led the development of advocacy letters to the Minister of Health endorsed by the South African National AIDS Council (SANAC) Civil Society Forum TB Task Team in 2023, 2024 and 2025. A key ask was the development of a public facing TB dashboard. On 24 October 2025, the National Department of Health launched a public facing dashboard with data available at district-level. At provincial-level, we developed an advocacy letter that was shared with the Head of the Western Cape Department of Health to scale-up TB testing.
- Piloting a TB Contact Card
TB Proof piloted TB Contact Cards at clinic-level to increase TB testing. These cards are a simple tool for TB staff to give to newly diagnosed TB patients (view the Contact Card here). To date a total of 485 TB Contact Cards have been distributed, with 83 returned (17%) which is encouraging progress. Since the start of the project, 126 contacts have been initiated on TPT (51 under 5 years and 85 over 5 years). The WC provincial DoH decided in September 2025 to roll out TB Contact Cards throughout the metro.
2. Policy and decision maker engagement to increase TB testing and support contact tracing, treatment and prevention
TB Proof conducted key stakeholder interviews regarding the implementation of the TB Recovery Plan and TB policies and published findings with recommendations to strengthen TB policy implementation in the BMC Global and Public Health (click here).
TB Proof co-developed advocacy letters that were sent to the Minister of Health and we presented key asks on behalf of the South African National AIDS Council (SANAC) Civil Society Forum TB Task Team (2023 letter here, 2024 letter here). We handed the advocacy letter to the Director General of Health at the closing ceremony of the 2024 TB conference and secured follow-up meetings between policymakers and civil society organisations to co-develop action plans to increase TB policy implementation.
Resources
- World TB Day videos click here to view
- TB champions videos click here to view
- Community TB stigma video click here to view the video
- Health worker TB stigma video click here to view the video
- Journal articles:
Analysing interventions designed to reduce tuberculosis-related stigma: A scoping review click here to read more
- Health worker TB stigma training video click here to view the video
- Champions in action videos click here to view videos
Our advocacy projects
TB Preventive Therapy
Some people may have latent TB – where some is infected by the TB bacteria but they do not show TB symptoms and cannot infect others.
CHW TB Champions
A community health worker (CHW) is a representative of a specific community. They have earned the communities’ trust to enter their homes and assist them to improve their health status.
For many years patients were given a difficult choice: die because of drug resistant TB or become deaf as a results of the treatment.
Healthcare workers (HCWs) are three times more likely to be infected by TB than the general public and six times more likely to be hospitalized with drug-resistant TB.
