“The Political Declaration signed at the United Nations High Level Meeting (UNHLM) on TB promised to treat 30 million people with TB Preventive Therapy (TPT) by 2022, but this is not currently the case. In South Africa, the TPT guidelines have been released recently but our communities are not aware of TPT. We should put our communities first as they are most affected by TB, they need to know what TPT is and who can have access to it.” – Phumeza Tisile, TB survivor, TB Proof.
In September 2023, world leaders will gather for the upcoming UNHLM on TB. In preparation for this, The Stop TB Partnership has compiled a report on the ‘key asks from TB stakeholders’ which highlights to ‘commit to prevent TB for those most at risk so that at least 35 million people (equivalent to more than 90% of those eligible) receive TPT, ensuring universal access to TB infection testing where needed and with new, effective short-course drugs and regimens, including for: 21 million contacts of people with TB who are five years or older including pregnant and lactating people; 8 million under-five child contacts and 6 million people living with HIV, adults as well as children’.
TB remains a leading infectious disease killer in the world. The World Health Organization reported that in 2021, 1.6 million people died of TB and an estimated 10.6 million people developed TB. TB killed 56 000 South Africans in 2021 and remains a leading cause of death in South Africa, despite it being a preventable and curable disease. TB is caused by a bacterium that is spread through the air when a person with TB of the lungs breathes, coughs or sneezes. The bacteria can stay in the air for a few hours, depending on the ventilation in the room. An uninfected person can inhale the TB bacteria and get infected with TB. This is called latent TB. Latent TB can progress to active TB (also known as TB disease, which can spread to others) in about one in ten people. TPT prevents a person with latent TB (where TB is in the ‘sleeping position’) to get active TB disease, where they will become sick, show symptoms and be able to spread the disease to others.
The South African National Guidelines on the Treatment of Tuberculosis Infection were recently released. We are excited to see the short course and the expansion of the inclusion criteria for TPT to:
- all TB contacts and
- high risk groups:
- all people living with HIV,
- people with silicosis
- other high risk groups including prisoners in correctional facilities, health workers and people who previously had TB.
The inclusion of short-course TPT has been shown to have a decreased risk of liver toxicity and other adverse events. By reducing tuberculosis infection in the country, it will lessen the burden on our health services and health workers. It will also ensure a better quality of life for many South Africans. TB interventions have been found to be among the most cost-effective of all public health interventions, with a return on investment of 43 US dollars for every 1 US dollar invested in prevention. TPT is vital for South Africa to reach its dream of a TB-free world.
- Why is tackling TB infection important in our fight against TB?
- What is the most important new shift in thinking that the guidelines bring?
- What changes are you hoping that these new guidelines will bring to our South African TB response?
- Why is the inclusion of shorter TPT regimens such as 3HP important?
- How can we gather momentum to support the implementation of this guideline?