Why a new approach is needed in the fight against South Africa’s number one killer

At the height of any one of the four Covid-19 pandemic waves over the past two years, no one can argue they did not know the status quo around this deadly virus. Regular televised country briefings by President Cyril Ramaphosa were accompanied by daily maps and infographics telling us which provinces were hardest hit. A USSD Covid-19 line was swiftly set up and data about caseloads was just a *120* away. Regular tweets delivered regulations and warnings about mask-wearing, hand washing and restaurant occupation rates.  

As South Africa navigated the Covid-19 pandemic there was a general consensus that the government had pulled out all the stops to keep the country just outside the proverbial door of the National Coronavirus Command Council’s head office. There is a reason that we could be kept abreast of the numbers in the way that we have.

Part of it is because the government set up intricate health data management systems to ensure that everyone could see the numbers and heed the calls of the government to manage the pandemic with the seriousness it deserved. 

What the response to the Covid-19 pandemic showed is that the health system has the resilience to respond in the face of a crisis. It highlighted the importance of reliable health data management information systems in responding to a pandemic. However, the country is facing a longer-term public health emergency in the shape of the TB epidemic, which, sadly, still kills close to 58,000 people annually. With access to treatment, TB is curable, which means that many of these deaths are avoidable.  

Although South Africa has implemented a system to integrate TB data at facility level, there is some incoherence around the data systems that are currently in place. As a result, there are major gaps in the data that we have around TB. 

This is problematic as the lack of reliable data means that to all intents and purposes we are flying blind. Put differently, if we can’t see the number of people who test positive for TB who are being initiated on treatment, the system is unable to respond timeously and runs the risk of increasing infection rates. The gap in data also makes it difficult to redirect funding to areas like community outreach programmes and it sets us back in reducing deaths.  

However, the challenges around the TB data are only one part of the problem. The bigger picture is a lack of political priority around TB, leading to compromised governance and leadership and virtually no accountability. 

It is unlikely that TB will get the same focus that the Covid-19 pandemic received. The dynamics around TB are vastly different and complex — ranging from the drivers of the disease to the stigma attached to it. 

However, it is important that South Africa build on the successes of its response to Covid-19 and think about how it can apply it to other diseases like TB. Despite TB being preventable and treatable, it still kills South Africans every day. In fact, TB remains South Africa’s number one killer  In 2019, 58,000 people died from TB. Last year this figure rose above 61,000.  

Given TB’s status as the leading cause of death and the fact that the response is meant to be grounded in a broader human rights framework through the National Strategic Plan for HIV, TB and STIs, it is important that this disease burden is tackled. In this vein, the health sector is duty-bound to urgently begin work on addressing and regaining the losses. 

(Photo: iStock)