Health and Wellness

(a)

(b) Tuberculosis remains a significant public health concern in the Western Cape. The province continues to experience high numbers of new infections, driven by socio-economic vulnerability, crowded living environments, HIV co-infection, and the impact of interrupted care during and after COVID-19. Drug resistant TB, including MDR-TB and XDR-TB, adds additional complexity to treatment and increases the burden on health services.

TB remains one of the leading infectious causes of illness in the Western Cape, and continued investment in early diagnosis, prompt treatment, community support, and prevention efforts is essential to reduce transmission.

(c) The Western Cape Department of Health and Wellness (WCDHW) faces several operational and public health challenges in managing TB, including:

• Delays in diagnosis for patients who present late or face barriers to accessing care,
• Drug resistant TB, which requires longer and more complex treatment and increases the need for psychosocial support.
• High-burden and rural areas where long distances, transport costs, and limited access to diagnostic services may delay patient care.
• Socio-economic drivers of TB, including poverty, overcrowding, and food insecurity, which increase transmission risk.
• Adherence challenges, particularly for patients on long treatment regimens who require sustained support.
• HIV co-infection, which increases vulnerability to TB and the risk of severe disease.
• Health system pressure, including staffing constraints within some facilities and the need for continuous training to manage DR-TB.

To address these challenges, the WCDHW continues to strengthen diagnostics through TB NAAT, urine LAM, gastric washings for children, chest X rays, and mobile X ray vans supported by the Global Fund. The Department supports decentralised treatment for drug resistant TB at primary health care level and maintains specialised TB hospitals across the province.