WHO Goals and Beyond: Managing HIV/TB Co-infection in South Africa

Abstract

The intricate relationship between HIV and TB, particularly in South Africa which grapples with an alarming prevalence of both diseases, presents a multifaceted challenge influenced by historical, social, and biological factors. This review explores the co-dependent nature of these diseases and the challenges to effective control strategies. The ramifications of Apartheid significantly shaped these pandemics, with TB thriving in impoverished conditions marked by overcrowding and limited health care access. Co-infection intensifies health challenges, further complicating treatment and management. Despite commendable efforts, achieving the ambitious “End TB” and “End HIV” goals set by the World Health Organization (WHO) for 2030 remains intricate due to socio-economic disparities, health care constraints, and political dynamics. The recent emergence of the COVID-19 pandemic introduced additional complexities, disrupting diagnostic and treatment services. Nevertheless, South Africa’s resilience is evident through destigmatisation campaigns, innovative preventative interventions, and significant contributions to global research. The importance of prevalence studies cannot be overstated; accurate data collection and analysis remain pivotal for informed interventions and tracking progress towards WHO goals. Here, we elucidate the need for a unified and comprehensive national response, supported by international collaboration, to effectively address the enduring HIV and TB burden within South Africa. As the nation navigates intricate historical legacies, social factors, and evolving health challenges, a crucial question arises: Will South Africa ultimately meet the WHO’s elimination goals or at least reduce the number of HIV-related TB deaths? Recognising potential obstacles, it becomes imperative to strategise responses to enable effective syndemic management and advancement towards WHO’s objectives.