Tuberculosis (TB) remains an urgent public health threat and a leading infectious cause of death from a single infectious agent, ranking above HIV/AIDS. In 2014, the World Health Assembly resolved to end the global TB epidemic by 2035 which led to elaboration of the Sustainable Development Goals and End TB Strategy’s vision of making a world free of TB with no deaths or suffering due to the disease beyond 2015. As for 2016, about 10.4 million people fell ill with TB while 1.5 million deaths were recorded worldwide.

An ominous increase is being seen globally in the number of new cases of multi-drug resistant TB (MDR-TB). Over half a million new cases resistant to rifampicin (RRTB) – the most effective first-line drug – was reported in 2016, 47% of these cases were in India, China and the Russian Federation. Treatment of MDR tuberculosis is complex and expensive especially its most severe, extensively drug-resistant (XDR-TB) forms. Treatment is long (at least 2 years), drugs are toxic (specific expertise is needed to manage adverse reactions) and outcomes are poor (with low success and high death rates).

In a bid to attain specific targets set in the End TB Strategy through multisectoral action to address socioeconomic determinants and consequences of TB, WACI Health led 18 South African civil society organizations (CSOs) including TB affected communities co-signed a letter appealing to Head of State (HoS), Ministry of Health (MoH) and Ministry of Foreign Affairs (MoFA) commitment to attending the TB High-Level Meeting (TB HLM). TB remains the leading reported cause of death in South Africa with over 33 063 deaths (8.4% of natural deaths) in 2015. Other pertinent issues raised by CSOs comprised of establishing a national TB Caucus, investing in research, diagnostics and treatment for TB, developing a retainment strategy for health care workers, prevention strategy for all and TB response based on human rights approach.

To achieve the 90% reduction in mortality and 80% in incidence requires provision of TB care and prevention within the broader context of universal health coverage (UHC), financing and technological breakthroughs among others. Following political commitment from the Prime Minister towards ending TB by 2025, India’s domestic resource budget, for instance was substantially increased in 2017.

South Africa CSO team in partnership with Global Fund flew their flag high as they met with their SA Mission in New York to engage with them on key asks and requesting their assistance to urge HoS to lead the delegation to TB HLM, and also make sure that National Consultation with all stakeholders is held prior TB HLM to agree on country’s commitments, targets and effective response to TB.

Through the continuous engagement in-country Minister of Health, Dr. Aaron Motsoaledi, in his closing remarks at SA TB Conference on June 15, 2018 said:

“I received many requests and pleas from many TB advocates, including those attending this conference that South Africa must ensure that the country must participate in the HLM at the high level of leadership in government. As TB HLM is on 26 September 2018, we have not relaxed. We are mobilizing for all heads of state of BRICS countries to attend without failure because 50% of all drug sensitive TB as well as 60% multi-drug resistant TB in the world are found in BRICS countries. Presently South Africa is holding the chairpersonship of BRICS and so at the World Health Assembly in Geneva in May I was chairing a BRICS Ministers of Health meeting and I was given an assurance by BRICS Ministers of Health that they will do everything in their power to have their heads of state attending the High Level Meeting on TB. In addition, we asked our President to raise it next month during the BRICS Summit. We are currently chairing SADC and we will do the same to urge all SADC heads of state to attend. There is a forthcoming AU summit and we will also raise this issue at that forum.”

This for us is positive way towards big win and hope in having the South African government leading Africa to attend TB HLM and respond to TB more effectively while meeting the 2030 targets.