WORLD TB DAY 2025 Yes! we can end TB if we commit, invest, deliver

THIS year's World TB Day's theme of increasing commitment, increasing investment and strengthening delivery of services is very appropriate in the era of a new world order and what some have called the end of the golden age of global health consequent to the policy changes by the Trump administration on foreign aid.

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How should we respond to this crisis in global health as well as the investment in TB research, development and service delivery? On the basis of global health solidarity, we can make a case for continued donor funding or we can rethink the commitment and investment, by governments of countries with high TB burdens to invest more in TB research and service provision. Even without donor support, South Africa has the means to eliminate TB.

The government provides significant amounts of funding for diagnosing and treating TB. It provides state-of-theart laboratory services as well as drugs and has well-qualified health workers to diagnose and treat TB. However, we know that TB is a social disease-people with poor nutrition and those living and working in overcrowded spaces, for example, are more likely to contract TB. This implies that a whole-ofgovernment approach is needed to eliminate TB. A good place to start to mark World TB Day is to review where the world and South Africa stand in the fight against TB.

According to the 2024 WHO report, 10.8 million people, globally fell ill with TB in 2023 with an incidence rate of 134/100 000. In addition, there were 1.25 million deaths attributable to TB (1.09m of whom were HIV-negative and 161 000 who were co-infected with HIV).

What does the South Africa data tell us? Like many parts of the world, the risk factors for TB in the country are being HIV-positive (and not on treatment), smoking, use abuse, diabetes and poor nutrition. Among this list, HIV is the most important risk factor in the country with a co-infection rate of about 50%.