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It is preventable.

And it’s curable.

But tuberculosis remains the leading cause of death in South Africa.

Statistics South Africa’s 2018 report on Mortality and Cause of death in South Africa, indicated that TB was the main cause of death in the previous three years, from 6.5% of total deaths in 2016 to 6.0% in 2018. 

It is alarming that TB continues to result in more deaths than diabetes, cerebrovascular diseases, heart disease and HIV.

While the statistics about TB infection rates – especially among youth – raise grave concerns, the hope of ending TB is emerging on many horizons as the struggle to eradicate the tiny bacteria intensifies.

But the efforts to build the youth with the capacity to take South Africa boldly into the future cannot be applied in one area alone. 

Building the youth

TB is one of many inter-related pandemics that persist to weaken our entire society – the list includes HIV, drug and alcohol abuse, gender-based violence, mental health and many forms of discrimination and marginalisation relating to gender and other choices made by adult individuals, epically those in the lesbian, gay and bisexual community.  

Riding the swelling wave of hope, Higher Health is pioneering innovative programmes for students at tertiary institutions, including several programs that tackle TB, HIV, GBV, mental health and many other health and social issues in an inter-related strategy.

We are building youth in their totality, not tackling one disease facing youth in isolation, by using the inter-sectional approach through innovative programmes like our co-curriculum and skills-building initiatives.

The co-curriculum is one of many inter-sectoral programmes pioneered by Higher Health at over 1000 colleges and university campuses in a cohesive response to the inter-related pandemics facing students throughout our country.

Putting things right for future generations

These programmes allow us to build skills around managing TB, HIV and many other issues with quality-assured inter-sectoral modules, thus building a future for our youth through innovative approaches.

We have a huge opportunity to put things right for all future generations of youth, and we can do it with one last push from all sectors of our society, from our nation rising as one to the challenge, and from the world heeding the UN’s call to urgent action by 2030.  

On the global front, the World Health Organisation’s theme for World TB Day 2023 should inspire hope in every country: ‘Yes! We can end TB!’.

This message resonates with us at Higher Health: we are also convinced that is possible to turn the tide against the global TB epidemic through high-level leadership, investment, innovation, accelerating action and collaboration. 

The meeting of Heads of State at the 2023 UN High-Level Meeting on TB at the General Assembly in September this year will heighten awareness and spur countries into action to prevent and fight TB.

The UN has set a goal of ending HIV by 2030. By then, 95% of communities must know their status, 95% of those who need treatment must get it and 95% of those who are on treatment must benefit from a reduced viral load.

In South Africa, a national TB Recovery plan is being implemented. 

New NSP must succeed

About 120,000 people who have tested positive for TB but have gone missing will be traced, and their treatment regimes will be strengthened. 

Improved methods of diagnosis were being used, and shorter treatment periods were being put in place.

The new 2023-2028 National Strategic Plan for HIV, TB and STIs announced on World TB Day by Deputy President Paul Mashatile focuses efforts on the elimination of both HIV and TB as public health threats.

The plan establishes measurable milestones for the next five years and is directly linked to the UN goals for HIV and TB.

The NSP was developed under the guidance of the South African National AIDS Council and brings together government, civil society, the private sector and development partners to eradicate TB.

Adding to the emerging hope comes the news that a drug-resistant TB regimen that is shorter and has reduced side effects is expected to be rolled out in South Africa soon.

Previously, patients had to take several drugs, injections, and combinations of drugs, but patients using the new drugs will have a 90% cure rate.

Inter-sectional approach

At our universities and colleges, Higher Health is riding the wave of global and national hope as we constantly improve and expand the programmes we offer to students who have contracted TB. 

The UN goal to end HIV by 2030 will only be achieved in South Africa if the NSP, which was announced on World TB Day, is successful in reducing the impact of TB. 

We know that TB worsens the HIV epidemic.

Our inter-sectional approach is proving to be a successful response to the inter-related range of epidemics facing the youth.

Tackling the impact of HIV and TB is one of nine priority areas in Higher Health’s civic education co-curriculum initiative. 

This unique inter-sectional programme runs alongside the academic programme and aims to protect students’ health and welfare while instilling constructive civic values. The other eight areas relate to gender-based violence, gender diversity and gender equality; mental, maternal and sexual health; disability; substance abuse and self-care.

We are building new generations of youth who have the capacity to overcome these challenges.

HIV is one of the main challenges in our country, and that is why the inter-sectionality of our curriculum is critical. Our Co-Curriculum is becoming increasingly important as a tool to build the youth by putting an end to the inter-related TB and HIV epidemics.

If we can control TB, we can control the impact of HIV

In 2021,104 242 students enrolled in the Co-Curriculum module dealing with TB, and this number grew to 194 758 last year.

In addition to the Co-Curriculum programme, another flagship project is our Skills Building programme for support staff at tertiary institutions. Last year over 8000 employees at these institutions were trained in issues related to HIV and TB through systemic infrastructural support programmes.

HIGHER HEALTH also operates mobile clinics that take health care programmes, including HIV/STI/TB and GBV prevention, into remote rural areas.

These clinics allow us to bring services to the doorstep of rural and peri-urban institutions, providing them with equitable access enjoyed by their urban colleagues.

We believe the first priority of every young South African is to look after their health and well-being while prioritising their education.

Our health programmes include peer-to-peer testing, screening and treatment campaigns and linkage to care.

Our methodology of each one reaching ten is part of the last big push we need to end the HIV pandemic, which will help us to overcome the TB pandemic through the inter-sectoral approach.

At Higher Health, our part in the plan starts at the source of the challenge. We provide youth-friendly health services focusing on screening and the early detection of risk factors, improved acceptability and access to services. Increasing access to health services for youth has long-term health benefits in averting severe conditions before they arise.

We have found that early health interventions among the youth promote healthy behaviour, reduce morbidity and produce tangible long-term cost savings by avoiding treatment costs.

The Higher Health model is to develop skilled and capacitated young South Africans from the post-school education system as critical enablers of community development.

We know that TB is curable with the correct, full course of treatment.

But we are also painfully aware that, if left untreated, about 50% of people with TB will die, and this rate is even higher among those who are immune-suppressed. Many of those who survive will be affected by chronic lung issues for the rest of their lives.

Adding to the trauma of TB, people who are not on treatment for TB of the lungs continue to pass the bacterial infection to those around them.

At the same time, the diagnosis of TB comes with social stigma, leaving people with the disease vulnerable to depression, anxiety, and other mental health issues. TB patients need support while working to regain their health.

We need a concerted effort from many sectors of our society, including health and education government departments, and the financial, social and political sectors.

Let’s reaffirm our commitment to collaborate and build the youth of the future, and let’s affirm together: “Yes, we can end TB!” – Health-e News

* Prof Ahluwalia is the CEO of HIGHER HEALTH, an implementing agency of the Department of Higher Education and Training (DHET). HH works in partnership with Universities South Africa (USAf), the representative body of the 26 public universities, and the South African College of Principals Organisation (SACPO), the representative body of the 50 Technical and Vocational Education and Training (TVET) Colleges, the public 26 Universities, the 50 TVET Colleges and the 9 Community Education and Training (CET) Colleges, across South Africa. HIGHER HEALTH is dedicated to promoting the health and well-being of over two million students in the post-school education system in South Africa. 

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