South Africa, Mozambique are global tuberculosis hotspots

Africa is advancing in the battle against tuberculosis (TB), yet unresolved cases and drug-resistant strains are complicating efforts, especially in South Africa and Mozambique. While progress has been noted, experts highlight that significant challenges remain in curbing the spread of the disease and reducing mortality rates.

Challenges in TB Control

South Africa persists as a critical area for TB. The World Health Organization (WHO) reported 54,000 fatalities from TB in 2024, a slight drop from prior years but not enough to signal victory. HIV co-infection rates, at 54%, amplify the burden, as weakened immune systems delay detection. Helen Hallstrom, a Senior Partnership Officer at ADPP Mozambique, explained, “People living with HIV often have compromised immunity if they don’t adhere to treatment, which leads to delayed diagnosis.”

“South Africa definitely has a higher burden because of the co-HIV infection rates,” Hallstrom told DW.

In Mozambique, the situation is equally dire. Over 112,000 individuals contracted TB in 2023, with 17,400 cases remaining undetected. The nation has grappled with drug-resistant TB for years, and despite its curability, the disease ranks among the top causes of death. Economic gaps, including persistent malnutrition and poverty, contribute to the crisis, according to Hallstrom.

Community Leadership in Mozambique

Modesta Antonio, a 67-year-old community leader in Mozambique, has emerged as a vital advocate for TB awareness. Without formal medical training, she has become a key educator in her district through local health programs. Such grassroots initiatives are proving effective in motivating testing and treatment adherence.

“Stigma is very high among people. By ensuring that people get more access to information to know what TB is and how you can prevent it is key,” Hallstrom emphasized.

South Africa’s national TB program has achieved notable success, with Deputy President Paul Mashatile noting a steady decline in new infections. “Our national TB program has achieved remarkable success in reducing the TB incident rate,” he said during a World TB Day event on March 24.

Digital Innovation and Awareness

Technology is also reshaping TB prevention. ADPP Mozambique employs the OneImpact platform, a community-led monitoring app developed by the Stop TB Partnership. Active in over 23 countries, the tool helps patients report discrimination, understand their rights, and maintain care connections. Local communicators are trained to use the app, which provides cost-effective social-technology support.

“Such efforts are highly effective in encouraging testing and treatment,” Hallstrom noted.

Health professionals stress that limited public understanding of TB symptoms continues to fuel the epidemic. Common signs like weight loss, persistent coughing, and night sweats are often mistaken for allergies, leading to delayed recognition of the disease.