South Africa Vows to End TB Epidemic Despite US Funding Freeze

South Africa remains determined to eliminate tuberculosis (TB) as a public health threat—even after the US froze critical funding that supported HIV and TB programs.

Deputy President and South African National AIDS Council (SANAC) chairperson Paul Mashatile made this clear during his keynote address at the World TB Day commemoration in KwaZulu-Natal on Monday. Despite the setback caused by the US President’s Emergency Plan for AIDS Relief (PEPFAR) funding freeze, Mashatile declared that “ending TB is within our reach.”

The TB Crisis in South Africa

South Africa is among the 30 high-burden countries responsible for 87% of global TB cases. In 2023 alone:

• 270,000 people were diagnosed with TB
• 56,000 lives were lost (153 deaths per day)
• An estimated 58,000 cases went undiagnosed

The country also faces a triple burden:

1. Standard TB
2. TB and HIV co-infections
3. Drug-resistant TB

Yet, TB is both preventable and curable, even for those living with HIV.

The “END TB” Campaign

To combat the epidemic, Mashatile launched the “END TB” campaign, aiming to:

• Test 5 million people by March 2025 (and annually thereafter)
• Reduce TB cases by 29%
• Cut TB deaths by 41% by 2035

PEPFAR Funding Gap & South Africa’s Response

The US government’s decision to withdraw 17% of HIV/TB program funding has forced South Africa to seek alternative solutions. The Department of Health is now tasked with emergency contingency plans to absorb the financial shock.

Mashatile emphasized the need for local leadership in health services:

“With a shift towards country-led service delivery, South Africa must strengthen sustainability planning at national and provincial levels. We need to rethink HIV and TB service delivery models.”

Despite funding challenges, free TB and HIV treatment remains available at all public health facilities.

A Call to Action

Mashatile ended with a powerful message:

“The fight against TB is a fight for justice, equity, and a healthier future for all South Africans. May we rise to this challenge together.”

South Africa’s battle against TB is far from over—but with strong leadership and public commitment, the country is determined to win this fight, with or without international aid.