Advocacy to strengthen TB Preventive Therapy (TPT) access in South Africa

Organisation: TB Proof – South Africa 

Improved access to TPT for at-risk populations in South Africa (SA) is the goal of the TB Proof project. The organisation contributed towards this by working with strategic partners, including the National TB advocacy network; to identify barriers to TPT scale-up, advocate for the release and implementation of new TPT guidelines and to increase community awareness and demand.

 TPT should be a key component of TB prevention strategies, yet it is currently underutilized in South Africa. As more evidence emerges supporting the introduction of shorter and safer TPT regimens, there is growing interest in the expansion of TPT. TB Proof aimed at building and strengthening partnerships with the SA TB Think Tank’s TB Prevention Working Group and other key stakeholders to scale-up policy preparedness, improve access to TPT and demand for its use at the community level. The organisation was well-positioned to undertake this project, since their members represent key affected populations who would benefit from and/or implement TPT, including people from informal settlements, TB household contacts and health workers. This project incorporated their insights, thus strengthening the success of our formulated advocacy strategies. “We explored barriers and facilitators to scaling up TPT by engaging stakeholders and TB affected communities, advocated for affected communities to participate in the development of new TPT guidelines and developed targeted advocacy strategies to accelerate access to TPT for people at increased risk of TB disease in SA,” says Wieda Human who led the project implementation.

 Most of the policy advocacy undertaken by TB Proof included advocating for the release and implementation of new TPT guidelines. This involved participation at various stakeholder fora, where pressure was put on the National TB Programme leaders to accelerate the release of the guidelines. As part of this, TB Proof also aimed to identify gaps or areas of improvement in these guidelines.

Below are some of the key recommendations made to the draft iterations of the South African TPT guidelines:

By attending stakeholder meetings, TB Proof strengthened collaboration within the national network of stakeholders and civil society representatives concerned with TPT. An advocacy letter, as supported by affected communities, was sent to Dr Yogan Pillay, Deputy Director-General at the time at NDoH, asking for a timely release of the national TPT guidelines.

To augment the policy work, campaign material was developed in order to increase awareness and to create demand for shorter and newer TPT regimens. These campaign materials contained scientific information on latent TB infection as well as community-based testimonials and stories of people who have had latent TB infection or those who have taken TB preventive therapy.

The NDoH were hopeful that they would approve the revised version and that they could release the Guidelines on 24 March (World TB Day), but unfortunately due to COVID-19, the review was postponed. The TPT videos were presented to an audience of health students and workers (just before COVID-19 lockdown) and were very well received. The videos were shared on our social media platforms for World TB Month and directly shared with other civil society organizations (CSOs) to ensure optimal reach. The response from many was positive, thanking us for making it easier for them to understand TPT.

We are proud of our contribution to TPT scale-up in South Africa! There is a need for continued advocacy to ensure timely release of the new guidelines and a rapid implementation plan so that communities can benefit from the donor-supported shorter 3HP treatment regime before the medication expires. We believe that this grant allowed TB Proof to strengthen the national network of TB advocacy partners and stakeholders and encouraged prioritization of TPT access. We envisage that the targeted engagement of civil society partners, including affected communities, will help develop and empower TPT champions who will continue to advocate for improved access to TPT and its expanded implementation in SA.

Written by Wieda Human, TB Proof Project Coordinator & Communications Officer and Dalene von Delft, co-founder of TB Proof 

Read more about the TB Proof campaign here.

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