HIV and TB Overview: South Africa

Strategic focus

The U.S. Centers for Disease Control and Prevention (CDC) began collaborating with South African non-governmental and community-based organizations in 1989 to address the country’s growing HIV epidemic. In 1995, CDC began working with the Government of South Africa to support the update of national HIV research, along with HIV and tuberculosis (TB) programs. With the launch of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003, CDC’s support in South Africa rapidly expanded. CDC prioritizes HIV treatment and prevention, and integration into clinical services, strengthening laboratory systems, improving health information systems, enhancing disease surveillance and response, and building public health workforce capacity.

Read more about CDC's most recent key activities and accomplishments below.

Building public health capacity

• Conducted disease surveillance with local partners, including the Human Sciences Resource Council, the National Institute for Communicable Diseases, and the South African Medical Research Council. This surveillance helped to better understand HIV prevalence, the national HIV response, and improve program implementation.

• Supported HIV population surveys like the surveillance of recent infections, drug resistance, mortality, and bio-behavioral surveys on people at higher risk for HIV.

• Sustained the use of existing information systems across the South African Government to plan human resources for health based on the burden of disease, individual health facilities characteristics, and community needs.

Strengthening laboratory systems and networks

• Increased laboratory diagnostic quality and public health laboratory services through accreditation and management of accurate lab results.

• Ensured facilities have access to laboratory information systems for timely results, proper documentation in patient charts, and electronic health information management systems.

HIV prevention and treatment

• Supported antiretroviral therapy (ART) treatment for over 2 million people living with HIV (PLHIV) in FY2024, 33 percent of the 6 million people who are on ART in South Africa.

• Supported South Africa with reaching 152,981 people at greater risk for HIV with comprehensive HIV and TB prevention, care, and treatment services in FY2024.

• Implemented evidence-based interventions to address factors that increase girls' and young women's risk for HIV.

• Helped reduce mother-to-child transmission rates of less than 1 percent at six weeks gestational age. In FY2023, maternal HIV testing coverage and maternal ART coverage was 100 percent.

• By the end FY2024, an estimated 96 percent of PLHIV knew their status, and 81 percent of them were receiving ART. Of those on treatment who had a viral load (VL) test, 97 percent achieved VL suppression below 1,000 copies/mL. Among children <15 years, 87 percent are estimated to know their status, of whom 70 percent are receiving ART, and 89 percent are virally suppressed.

Tuberculosis prevention and treatment

• In the districts supported by CDC, 88 percent of TB patients were tested for HIV in FY2024, and 50 percent had both, HIV and TB. Of those with HIV and TB, 72 percent received ART in addition to TB treatment.

By the numbers

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