#InTheSpotlight | Diabetes is a leading killer in SA – yet we don’t know who has it or where they are

Diabetes is the second leading cause of death in South Africa after tuberculosis, according to Statistics South Africa. It is the leading cause of death in women. Yet, despite being a major driver of deaths and illness, we do not have a clear picture of how many people in the country have diabetes or how many people are receiving diabetes care. This leaves our health system ill-equipped to handle the growing diabetes crisis.

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New TB drug shows promise, but experimental vaccine disappoints

While three new tuberculosis (TB) medicines have been registered in South Africa over the last decade, TB treatment still comes with several side effects and requires taking multiple different medicines, typically for six or more months. The search for better TB medicines got a boost last week with the presentation of promising findings from a study conducted in South Africa on an experimental drug called quabodepistat. Elri Voigt reports on this and other TB studies presented at the Conference on Retroviruses and Opportunistic Infections (CROI) in Denver, Colorado.

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EDITORIAL: With elections and NHI, this is a big year for healthcare in SA

South Africa is barrelling towards its most consequential and most competitive national and provincial elections since 1994. Spotlight editor Marcus Low asks what is on the line in these elections from a healthcare perspective and argues that the stakes are particularly high when it comes to NHI and the Gauteng and KwaZulu-Natal provincial health departments.

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Antibiotic slashes risk of drug-resistant TB in kids, finds major SA study

Tuberculosis (TB) preventive therapy has been transformed in recent years, with treatment duration having been cut from six or more months to just three or one. Progress in developing new treatments to prevent drug-resistant forms of TB has however lagged behind, especially in children. Elri Voigt unpacks findings from a major new TB prevention study presented at the Union World Conference on Lung Health last week and plans for another important preventive therapy trial set to start soon.

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Interview: “Someone had to do it”, says SA TB activist on Time 100 list

At the age of 19 Phumeza Tisile contracted multidrug-resistant tuberculosis. For four years she battled the disease, losing her hearing in the process. At one stage, a doctor told her to visit a priest and prepare her soul for death. Recently, Tisile (now 33) made it on to TIME magazine’s 2023 TIME100 Next list, as one of 100 emerging leaders round the world who are “shaping the future and defining the next generation of leadership”. Sue Segar chatted to Tisile about her remarkable journey.

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In-depth: SA’s remarkable TB clinical trial capacity

Several of the world’s most important tuberculosis clinical trials of the last two decades were done in part or entirely in South Africa. Tiyese Jeranji chatted to some leading researchers about where the country’s clinical trial capacity comes from and what is needed to maintain and improve it.

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Interview: “The situation is not going away,” says inspiring TB doctor

Dr Juli Switala (42) has treated children in Nigeria, helped fatally ill patients during the 2014 Ebola outbreak in Sierra Leone, and delivered babies at a hospital in Afghanistan against a backdrop of upheaval and violence. But nowhere cuts close to her heart quite like Brooklyn Chest – the tuberculosis (TB) hospital on Cape Town’s north-western fringes. Biénne Huisman chatted with Switala about her work in hospitals around the world, the challenges of treating kids with TB, and going for a run to get away from it all.

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In-depth: Can CO2 monitors help protect healthcare workers from TB?

A recent study published in the journal Clinical Infectious Diseases found that there was an association between healthcare workers’ exposure to high levels of carbon dioxide (CO2) and their risk of being exposed to tuberculosis (TB). Elri Voigt unpacks the study’s findings and asks experts how CO2 monitors work, how well they predict the risk of TB exposure, and in which settings these monitors might be most useful.

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Interview: “The only good TB bacillus is a dead one”, says UCT’s Prof Valerie Mizrahi

Professor Valerie Mizrahi, a world-leading tuberculosis researcher and director of the Institute of Infectious Disease and Molecular Medicine at the University of Cape Town, is retiring at the end of the year. Biénne Huisman sat down with Mizrahi to talk about her journey in TB research, passing the baton to a new generation of researchers, and how she helped build a research ecosystem that brings together specialists across the basic, clinical, and public health sciences.

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In-depth: Why an Eastern Cape TB hospital closed and what comes next

Two years ago Orsmond TB Hospital in Nelson Mandela Bay closed its doors as a result of dwindling patient numbers. The closure made headlines for the fact that 45 staff members continued to be paid despite the closure. Luvuyo Mehlwana takes a closer look at both the situation at Orsmond and the wider trend of TB hospitals being closed or repurposed.

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Opinion: A UN meeting on TB is at best a means to more important ends

On September 22 ministers, heads of state, and other officials from around the world will gather in New York for the second United Nations High-Level Meeting on TB. Yet, a few months ago it was not the governments these officials represent, but two philanthropies that stepped in to ensure arguably the most important TB trial of the decade has the funding needed to proceed. Marcus Low contrasts commitments made at the previous UN High-Level Meeting on TB with recent data on funding for TB research and asks what this tells us about the state of the global response to an age-old killer.

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