How South Africa is intensifying efforts to combat HIV-TB co-infection

In South Africa, the intersection of TB and HIV remains a significant health challenge. File picture: Pexels

In South Africa, the intersection of TB and HIV remains a significant health challenge. File picture: Pexels

Published Mar 13, 2024


In South Africa, the intersection of tuberculosis (TB) and HIV remains a significant health challenge and TB accounts for most deaths among individuals living with HIV.

In a bid to tackle this dual threat, the Department of Health has launched a concerted effort to integrate HIV and TB services within healthcare facilities, aiming to accelerate testing and treatment initiation.

Lucy Connell, TB Programme Lead at health non-profit Right to Care, highlighted the historical separation of HIV and TB management within facilities.

Previously, patients endured the inconvenience of navigating separate queues, consulting rooms, and files for each condition. This often deterred many from seeking necessary care.

However, recent reforms have streamlined the process, allowing patients to undergo screening, counselling, and testing for both HIV and TB in a single visit, facilitating a more holistic approach to healthcare delivery.

As part of TB Awareness Month in March, Connell encourages individuals to test themselves at the nearest health facility, emphasising the crucial role of early detection and treatment initiation in curbing TB transmission.

She stresses the importance of building immunity through antiretroviral treatment for HIV-positive individuals.

The integration of HIV and TB services receives support from various stakeholders, including the United States Agency for International Development (USAID).

Furthermore, efforts to decentralize services for drug-resistant TB (DR-TB) continue to reduce the burden on patients. This ensures accessibility to specialised care and shorter treatment regimens.

In addition to clinical interventions, efforts are underway to address the social stigma associated with HIV and TB, with a focus on providing psychosocial support and promoting treatment adherence.

The country’s multifaceted approach to combating HIV-TB co-infection underscores a commitment to improving patient outcomes and advancing public health goals.


Around 59% of TB-diagnosed individuals are HIV positive in South Africa.

TB accounts for the majority of deaths among people living with HIV.

In Mpumalanga’s Ehlanzeni district, 77% of patients completed short regimen treatment for multi drug-resistant TB in 2022, exceeding the national average success rate.

What is tubercolosis or TB?

TB is a contagious infection caused by a bacteria that usually attacks your lungs. It can spread very easily and in addition to that, can be deadly.

When you have active lung TB and you cough, talk, sneeze or spit, you emit germs into the air and anyone who breathes in these germs can become infected. TB is curable if detected and treated early.

What are the symptoms of TB?

TB symptoms can include coughing, chest pain, loss of appetite and weight, coughing up blood, night sweats, fever, tiredness and weakness, shortness of breath and difficulty breathing.

It is also noteworthy that many people infected with TB don’t present or have symptoms.

Individuals at risk should screen for TB at their closest facility.

The ones most at risk are people living with HIV, women who are pregnant, people who are close contacts of a person diagnosed with TB, and people who have been on TB treatment within the last two years.

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