Globally, South Africa is one of 14 countries with high burden of TB, HIV and DR TB. Although the country is making important gains in responding to the TB epidemic, TB remains a major public health challenge in the country. Of the estimated 301,000 people who fell ill with TB in 2018, the country notified only 228,000 TB cases while an estimated 73,000 were not notified or diagnosed (WHO, 2019). TB remains the leading cause of death in South Africa with 64,000 deaths recorded in 2018 (WHO, 2019). HIV-positive individuals and child contacts of TB cases are at high risk of TB and need TB preventive therapy. However, only 65% of the HIV positive patients newly enrolled in care were initiated on TB preventive therapy and 59% of children < 5 years who were TB contacts were initiated on TB preventive therapy in 2018.
SANOFI is a key partner to the South African government in its national response to achieve the global health goal of ending the TB epidemic, with targets to reduce TB deaths by 95% and to cut new cases by 90% between 2015 and 2035 (WHO , 2014). The vision for the country as pronounced in the National Strategic Plan for HIV, TB and STIs 2017 to 2022 is “A South Africa free from the burden of HIV, TB and STIs” (SANAC, 2017). Strategies include accelerating prevention to reduce new TB infections by increasing uptake of TB Preventive therapy and promoting TB infection control. To reduce morbidity and mortality from TB, the country is implementing the 90-90-90 strategy for TB focusing on ensuring early diagnosis and appropriate treatment for patients with all forms of TB. This includes supporting patients to adhere to treatment (SANAC, 2017).
SANOFI plays a key a role in TB prevention and reducing morbidity and mortality from TB. The Sanofi TB portfolio addresses management of latent TB using Preventive TB treatment (prophylaxis), Drug Susceptible (DS) TB treatment and Drug Resistant (DR) i.e. Multi and Extensively drug resistant (MDR & XDR) TB treatment. The company aims to improve the prevention, diagnosis, management and care of persons with TB, TB/HIV and multi drug-resistant TB (MDR-TB) by building capacity of health care providers through training and dissemination of tools and job aids making implementation of the TB programme simpler.
On an ongoing basis Sanofi supports local researchers and research institutes with funding or product for investigator-initiated studies that help generate new knowledge of the South African epidemic, develop new diagnostics and new treatment delivery models. Through scientific symposia and continuous healthcare practitioner engagement, Sanofi disseminate new knowledge and new ways of managing TB.
SANOFI has supported the development of mobile health tools ( https://www.vulamobile.com/) that make it easier for Primary health care workers to refer patients to specialists making the referral process much quicker. In addition, the company engages with the private sector and community NGOs to support patient’s adherence to improve treatment outcomes. This is done through the development of patient education materials which are distributed through the health care providers.
SANOFI is committed to local manufacturing. Sanofi manufacturing site in Waltloo, near Mamelodi has created employment opportunities for over 300 employees and contractors. The Waltloo plant is a leading producer of TB and Central Nervous System (CNS) disease medicines in South Africa. The company also exports TB medicines produced at Waltloo to other countries including Zambia/Angola/Mozambique/ Botswana/Namibia and Kenya. Plans to supply to the rest of the world are under way.
SANAC. (2017). Let Our Actions Count: South Africa's National Strategic Plan for HIV, TB and STIs 2017-2022. Pretoria.
WHO . (2014). The End TB Strategy: Global strategy and targets for tuberculosis prevention, care and control after 2015. WHO.
WHO. (2019). Global Tuberculosis Report 2019. Geneva.