Zimbabwe TB Battle Shifts to Drug-Resistance & Missed Cases
n By Delicious Mathuthu n nn n Kwekwe - Zimbabwe has achieved a major public health milestone by being removed from the world's top 30 list of countries heavily burdened by Tuberculosis (TB). n nn n The nation, however, is now confronting a
anostrofy By Delicious Mathuthu
Kwekwe - Zimbabwe has achieved a major public health milestone by being removed from the world's top 30 list of countries heavily burdened by Tuberculosis (TB).
The nation, however, is now confronting a complex and significant challenge defined as a "double burden" of TB/HIV co-infection and Multi-Drug Resistant TB (MDR-TB).
The context was shared by Dr. Manners Ncube (pictured) from the Ministry of Health and Child Care's National TB and Leprosy Control Programme during a sensitization workshop for radio presenters, journalists and other stakeholders from across the country, held in Kwekwe; focusing mostly on Drug-Resistant (DR) and Multi-Drug Resistant (MDR) TB.
Dr. Ncube presented data showing that while progress has been made, the fight is far from over. He said the latest information estimated TB incidence, for 2024, at 203 per 100,000 population.
He said a critical concern is the high number of undiagnosed cases, with an estimated 14,000 cases missed in the same year.
He said almost half of the people diagnosed with TB had HIV.
"TB/HIV co-infection rate was 49% in 2024, a drop from 54% in 2021," Dr. Manners said.
To combat this, the National TB and Leprosy Control Programme has set aggressive strategic goals for 2026 which include efforts to reduce the incidence of all forms of TB by 80%, from 242 per 100,000 in 2015 to 48 per 100,000; increasing the treatment success rate for patients with Rifampicin Resistant (RR)/MDR TB to 75%, Dr. Manners said.
He further pointed that decreasing the proportion of households facing catastrophic costs due to TB from 80% to 50% is part of the strategy.
The country has invested heavily in diagnostic infrastructure, now boasting 188 Gene Xpert machines, 18 of which are XDR-enabled, 20 Truenat machines and 61 digital X-ray machines in the public sector.
GeneXpert machines are a fast, automated 'lab in a box' used by health workers to quickly detect diseases, most notably TB, often in about an hour or so.
It works by taking a patient sample, like spit, in a specialized cartridge and automatically finding and rapidly copying the disease's unique DNA/gene code.
The technology is crucial as it allows doctors to start the correct treatment immediately, often even checking for drug resistance, without having to wait weeks for results from a distant, specialized laboratory.
Despite this, challenges persist, Dr. Manners said, including "thin cartridge stocks for the Xpert MTB/Rif assay."
MTB refers to Myco-Tuberculosis Bacillus, the actual germ that causes TB, a test looking for the genetic code of this germ, with RIF representing Rifampicin, the most important and common medicines used to treat TB.
DR. Manners further said difficulties with the logistics of access versus user fees at public institutions, and a need for improved monitoring and follow-up in DR-TB care, are part of challenges being faced.
Other challenges are that basic medicines are not always readily available, barriers in social support logistics, reduced partner support and capacity building platforms like site level trainings and entoships.
He said an anti-TB drug resistance survey is also needed for Zimbabwe.
Meanwhile, a crucial element in the fight against TB's social barriers is the OneImpact Zimbabwe initiative, spearheaded by the Jointed Hands Welfare Organisation (JHWO).
The project implements a Community-Led Monitoring (CLM) system using the innovative mobile application (app).
The app is designed to empower people affected by TB to claim their rights, access health and support services, and report and eliminate TB stigma and discrimination easily.
Making a presentation during the same workshop, JHWO Director, Dr. Donald Tobaiwa said the OneImpact app combats stigma at individual and community levels while generating essential data for the National TB Program.
The CLM system monitors the health services based on five indicators, which are availability, accessibility, acceptability, affordability and appropriateness, he said.
The data gathered so far, he said, highlights that the most common challenges reported by users are related to self-stigma, stigma at community level and at the workplace, limited counselling and lack of access to social support.
Dr. Tobaiwa said the program, which was officially launched in March 2023, has demonstrated significant engagement, with 10,098 people engaged and 64% of reported challenges resolved; with about 289 out of 413 reported challenges as of October 28, 2025.
Some common signs if one has TB include, but not limited to, night sweats, fever, loss of weight, cough for a week or more, or any duration in HIV recipients of care patients, difficulty in breathing and general body weakness; other signs and symptoms depend on the site affected by the virus.
