Pretoria – Unitaid and South Africa’s National Department of Health have launched a partnership to accelerate the country’s efforts to prevent and treat HIV and tuberculosis. South Africa is home to the world’s biggest HIV/AIDS epidemic, as well as one of the highest TB burdens.

The joint endeavour will introduce HIV self-screening, expand access to prevention for adolescent girls and young women at high risk of HIV infection, and to TB preventive therapy for people living with HIV and children under the age of five. It will also support the development of better first-line HIV treatment, and efforts to find better and shorter treatment for multidrug-resistant TB.

“We are very excited to partner with the South African government to accelerate the introduction of health innovations to prevent, diagnose and treat HIV and TB,” Unitaid Executive Director Lelio Marmora said. “Through this partnership we hope to boost HIV testing, particularly among adolescent girls, young women, and men, and ensure they have access to treatment.”

South Africa is at the forefront of the global AIDS response and has made significant progress in getting people to test for HIV in recent years.  Although South Africa has the world’s largest HIV treatment programme, the country still faces challenges in preventing new infections and reaching the one million people living with HIV who do not know their status.

HIV self-screening is a new, cost-effective way of testing hard-to-reach populations, including young people, men, female sex workers and men who have sex with men. Through its HIV Self-Testing Africa (STAR) project, Unitaid is helping to close the testing gap in six countries in eastern and southern Africa, including South Africa. It is working with the health department and its implementing partners—Society for Family Health, the Clinton Health Access Initiative, the Wits Reproductive Health and HIV Institute and Population Services International—to ensure that HIV self-screening is included in the national HIV programme.

In 2017, the South African government began offering pre-exposure prophylaxis (PrEP)—a highly effective daily pill to prevent HIV—to adolescent girls and young women.  Unitaid is working closely with the health department and the Wits Reproductive Health and HIV Institute to generate data on how to best deliver PrEP.

TB is the leading infectious disease killer globally and the leading cause of death in South Africa. An estimated 80% of South Africans are infected with TB bacteria, the vast majority of whom have latent TB rather than active TB disease. People living with HIV are 20 to 30 times more likely to develop active TB disease than people not infected with HIV.

People with latent TB have Mycobacterium tuberculosis in their body, but it is inactive; a normal immune system prevents it from causing illness or becoming contagious. However, latent TB bacteria can ‘wake up’, even many years after their arrival in the body, and cause illness. People with weakened immune systems are particularly susceptible to developing active TB.

As South Africa works to end TB, its highest priorities are treating people with multidrug-resistant TB and providing preventive therapy to high-risk populations, including people living with HIV.

With Unitaid funding, The Aurum Institute is scaling up access to affordable short-course preventive therapy for TB, known as 3HP, for people living with HIV and children under age five. The project seeks to establish 3HP as an affordable, less-toxic therapy suitable for wide introduction in 12 countries most affected by TB, including South Africa.

The endTB project, implemented by Partners in Health, Médecins Sans Frontières and Interactive Research and Development, supports the introduction of the first new medicines for drug-resistant TB in nearly half a century in 17 countries, including South Africa.

“These new HIV and TB prevention technologies could have a major impact on the trajectory of the HIV and TB epidemics in South Africa,” said South Africa Minister of Health Aaron Motsoaledi. “We are delighted to be working with Unitaid as we aim to reach the Sustainable Development Goal targets of ending TB and HIV by 2030.”

The partnership announcement was made on the eve of World TB Day during a partners meeting organized by Unitaid on innovations to prevent, diagnose and treat HIV and TB in South Africa.

Unitaid has committed more than US$ 50 million to this multi-year partnership.

Media contacts 

Unitaid : Dominique De Santis (in Pretoria), desantisd@unitaid.who.int, cell. +41 78 911 5327

National Department of Health : Popo Maja, popo.maja@health.gov.za, cell. +27 82 373 1169