The World Health Organization (WHO) Global Tuberculosis Report 2021 notes that more than 1 million children worldwide were diagnosed with TB in 2020, and a quarter of these children died from the disease.

Speaking at the SA TB Conference in Durban, Dr Karen du Preez of the Desmond Tutu TB Center says only 400,000 children are on treatment, according to the WHO.

Du Prez also touched on the number of undetected cases of tuberculosis in children.

“We are still missing many young children, so it is estimated that about 70% of our children are missing. So we really need to focus on diagnosing these children… We need to get the basics right. Nothing beats a good history, clinical assessment, and careful follow-up. This is a really powerful tool that works with children. And we really need to train our health workers to be able to confidently diagnose children with TB at the primary care level.”

A collaborative approach

Stakeholders at the SA TB conference in Durban say TB can only be eradicated through a collaborative approach without a bunker mentality. Health experts, civil society and government have come together to examine why existing screening and treatment systems are not delivering meaningful results.

It will take all of us, not some of us. This is a message from doctors, TB advocates, health funding organizations and government on how South Africa can continue its fight to end TB.

WHO lists South Africa as one of the 30 countries with a high burden of tuberculosis, with a high rate of co-infection with HIV and tuberculosis of more than 60%.

Along with earlier calls at the meeting for increased investment in diagnostics to close the gap between testing and treatment, voices across the TB landscape are confident that the solutions lie in the communities most affected by TB.

An example of this is the Treatment Action Campaign (TAC) model. The aim of the community-led monitoring project is to hold governments and aid organizations accountable by monitoring community and health centers across the country.

TAC’s Buta Mpofu says: “The Ritshidze project currently oversees over 400 clinics and community health centers in 29 districts across 8 provinces in South Africa. We’d say it’s the world’s largest community-led monitoring company, and it’s only going to get bigger. We are going to add another 200 sites over the next year.”

Stakeholders discuss airborne diseases at the 7th South African Tuberculosis Conference in Durban.

A similar message from Show Me Your Number director Mabalane Mfundisi. The organization is part of the Civil Society Forum of the South African National AIDS Council.

“They live among us and we can’t find them, and if we do find them, they’ll have to provide services. Not just at the facilities level, but we have to get the facilities to where the people are. It’s one thing to say we have the medicine and another to say it’s not actually available,” Mfundisi explains.

Key issues were raised by Dr. Enos Massini of the Global Fund. The Foundation is a global partnership to fight tuberculosis, HIV and malaria. South Africa is among the countries that fund the fight against tuberculosis. Masini, however, questioned why South Africa still suffers from a lack of policy implementation.

Massini says, “We have evidence-based interventions and the introduction of new tools, but why do we still have a relatively large number of TB patients who have gone untreated?” Tools and innovations alone will not be able to reach people. And that’s why there is a need for constant improvement, effective implementation, so that the tools do what they are intended for.”

Wide applause followed calls from civil society to declare a tuberculosis emergency in South Africa.

The global death rate from tuberculosis remains alarmingly high, despite the fact that the disease is curable.

More than 4,100 people die from tuberculosis every day

The world needs a TB vaccine to reduce deaths by 95% by 2035, says University of Cape Town chief scientist Dr Angelique Luabeya.

Statistics from the United Nations Joint Program on HIV/AIDS-UNAIDS showed that more than 4,100 people die of tuberculosis every day worldwide.

Luabeya says that the old BCG vaccine is not strong enough because it does not protect against critical pulmonary tuberculosis.

“We need a vaccine against tuberculosis, the tool we have will not help us achieve the goal. But if we introduce a new TB vaccine, it could speed up our efforts to reach the target by 2035. But we have to ask ourselves why we need a TB vaccine so long, we have BCG vaccine which is 100 years old. It has limitations in reducing or controlling the TB epidemic.”

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