Close collaboration between researchers and community groups has been instrumental in South Africa’s significant success in reducing tuberculosis (TB) incidence by more than half over the past decade. Women researchers and advocates have played a central role in this fight, with South African scientists contributing to global breakthroughs in TB research. This progress was highlighted during a webinar co-hosted by Global Health Strategies, Bhekisisa, and Health Policy Watch.
However, a sudden loss of $34 million in donor funding from major programs such as USAID and PEPFAR threatens to undermine these gains. The funding cuts are projected to result in 580,000 fewer people tested for TB and 35,000 fewer receiving treatment this year, putting millions at risk in a country where TB causes over 56,000 deaths annually.
Leading researchers emphasized that South Africa’s achievements have come from strong integration and coordination across basic science, clinical research, public health, and community engagement, all driven by a shared vision. Women have been at the core of this multidisciplinary approach. Advances in diagnosis, treatment regimens for drug-resistant TB, and innovative tools like oral swab self-tests are among the country’s pioneering contributions.
Despite this progress, the funding cuts have severely impacted research efforts, including crucial community engagement and targeted programs for vulnerable groups. Many frontline and technical staff have lost their jobs, and some specialized programs have disappeared. This disruption threatens patient access to care, especially for those living with HIV who are more susceptible to TB.
Community advocates reported that TB testing rates have fallen, clinic waiting times have increased, and educational campaigns on TB and HIV have been curtailed. The national “End TB” campaign aims to test five million people by next year, but funding currently only covers three million tests. Experts warn that South Africa’s TB sector is underfunded and faces an urgent need to secure sustainable resources.
With global funding sources shifting priorities, South African experts stress the importance of taking greater ownership and responsibility within Africa to support TB control. They call for making a compelling case to donors and finding innovative, resource-efficient approaches to continue combating TB amidst competing public health priorities.
The consensus among leaders is clear: TB remains a severe public health crisis requiring urgent prioritization, better information sharing, collaboration, and increased investment—particularly from the private sector—to sustain the hard-won progress and save lives.
